Challenger Cesarean Delivery

Background and Context

• Economic Issues
• Cesarean Delivery Rates: Goals vs. Reality
• Types of Physicians Performing Cesarean Delivery

Indications for Cesarean Delivery

• Indications
• Repeat Cesarean
• Diagnosis of Dystocia
• Non-Reassuring Fetal Heart Rate

Preparation for Surgery

• Preparation for Surgery
• Role of the Surgical Assistant
• Operative Note

Surgical Technique

• Simplified Technique
• Difference from the Pfannenstiel Technique
• Illustrated Steps

Options in Surgical Technique

• Abdominal Incision
• Visceral Peritoneum
• Opening the Uterus
• Delivery of the Placenta
• Closure of the Uterus
• Peritoneal Closure
• Subcutaneous Tissues
• Skin Closure
• Final Check of the Uterus
• Perimortem Cesarean Delivery

Postoperative Care

• Postoperative Orders
• Counseling Points

Complications

• Identifying Patients at Risk for Surgical Complications
• Abdominal Dystocia
• Cesarean Delivery in the Patient with Chorioamnionitis
• Uterine Hemorrhage
• Bladder Injury
• Bowel Injury
• Postoperative Fever
• Thromboembolic Complications