Vertical caesarean section up to several times. If it is a vertical cut wound, then at present, it can only be combined with this vertical cut. Basically, it is not recommended to do this kind of cesarean section more than three times, at most two times. It is clinically acceptable, and most doctors dare to do this operation. Exceeding this figure is more difficult and risky.
Under what circumstances is pregnant women suitable for vertical cutting?
Doctors will judge according to the classification of wounds.
1. Transverse wound: the height of the wound is about 3 or 4 cm above the pubic symphysis, and the length of the wound is about 10- 15 cm. The skin, subcutaneous tissue and fascia are all transected, but when they reach the rectus abdominis, they are cut longitudinally at the midline and enter the abdominal cavity.
2. Longitudinal cut wound: the wound is between navel and pubic symphysis, and the length of the wound is about 15 cm.
Cross-cutting and vertical cutting are only a matter of surgical incision selection. Crosscutting is a surgical method initiated by Israelis, which is mainly beneficial to extubation early after operation, and the pressure on incision due to gravity is less. Regardless of transverse cutting or vertical cutting, it is emphasized that the second pregnancy must be three years later, otherwise uterine rupture will easily occur.
There are three kinds of wounds that cut the uterine wall.
1, longitudinal section of upper uterus: this is a traditional caesarean section;
2. Longitudinal cutting of the lower uterine segment;
3. Transverse cutting of the lower uterine segment;
At present, the third method is the most common and safest, and the first and second methods are only used in emergencies.
Whether caesarean section is done vertically cannot be accurately said whether it is done horizontally or vertically. It is necessary to decide whether to cut horizontally or vertically according to the specific situation of pregnant women and fetus analysis. Usually, more pregnant women choose crosscutting. Because the position of the cross-cutting caesarean section incision is relatively low, it is more beautiful when it is not obvious, and the tension of the cross-cutting incision is relatively small, which makes it easier to heal.
In fact, transverse incision also has some disadvantages, because the tissue structure of the human body can be known that the muscles, blood vessels and nerves of the human body are longitudinal. Cesarean section transects the human tissue in the opposite direction, which may cause wound adhesion. This situation is more harmful to human body than longitudinal cutting.
If there are women who are going to have a second child, it is best to choose vertical cutting. Although vertical incision is not so beautiful, it is a more scientific surgical method and more suitable for taking out children. Moreover, when there are some bad situations during the operation, the vertical incision is easier to carry out emergency surgery in an emergency.
Disadvantages of longitudinal incision
1. Abdominal wall scar is obvious and unsightly, especially for people with scar constitution.
2. It is heavier to pull up and lie down, so the parturient feels more pain.
3. There are more patients with poor wound healing than transverse incision, especially those with thick abdominal wall, which is easy to cause fat liquefaction or infection.
Disadvantages of transverse incision
1. Surgery takes a long time and requires high anesthesia, which is more suitable for elective surgery.
2. The extension of incision is limited, and the field of vision exposed during operation is limited, so it is impossible to explore widely.
3. The time from skin incision to fetal delivery is longer than that from longitudinal incision.
4. Due to the influence of wound length, delivery of fetal head is more difficult than longitudinal cutting.
5. The postoperative adhesion of each layer incision is heavier than that of the longitudinal incision, and the reoperation is more difficult than the longitudinal incision.