Cesarean Delivery, Emergency: Risks/Benefits

Risks/Benefits

1. Risks:
   • infection;
   • injury to maternal tissues and internal organs;
   • injury to fetus at delivery;
   • need for application of vacuum or forceps to expedite delivery in cesarean section;
   • 10% of patients undergoing emergent CD require transfusion due to severe maternal hemorrhage;
   • risks of transfusion reactions and acquired infections from blood products;
   • risk of hysterectomy for intractable uterine hemorrhage;
   • risk from administration of aneathesia;
2. Benefits
   • decrease in short- and long-term morbidity;
   • in cases of severe maternal hemorrhage, maternal morbidity and mortality are decreased.
3. Complications
   1. Infection:
      • wound infection;
      • wound dehiscence;
      • wound seroma;
      • wound hematoma;
      • uterine infection,endometritis;
      • pneumonia;
      • UTI;
      • pyelonephritis;
      • mastitis;
   2. Thromboembolic events:
      • DVT/PE (deep venous thrombosis/ pulmonary embolism);
      • septic pelvic thrombophlebitis;
   3. Hemorrhage/Bleeding:
      • Fatigue;
      • Orthostatic hypotension with syncope;
      • Iron deficiency;
      • Need for transfusion;
      • Need for hysterectomy;
      • Maternal mortality;
   4. Injury to internal organs
      • bladder injury requiring prolonged catheterization;
      • ureteral injury;
      • bowel injury with or without colostomy;
      • bowel resection due to extensive injury;
      • excision of fallopian tube and/or ovary for the control of severe hemorrhage;
   5. Risk of anesthesia:
      • aspiration of gastric contents;
      • high spinal with need for endotracheal intubation;
      • inability to ventilate with maternal hypoxia and brain injury;
      • maternal mortality due to hypoxia or cardiovascular collapse.