Cesarean section is a procedure taken by a doctor to remove the fetus and its appendages through a transabdominal incision of the uterus during labor, when the fetus cannot be delivered naturally due to maternal or fetal reasons. Because of the large wound and extensive trauma of this procedure, postoperative complications can easily arise, so good postoperative care is the key to a smooth recovery.? We will discuss the post-cesarean delivery care step by step as follows.
1. Early activity
Purpose: Prevention of thrombophlebitis
Deep vein thrombosis of the lower extremities is more likely to occur in late pregnancy and postpartum, and it is more likely to occur in patients who had cesarean delivery. Risk factors for this disease include obesity, inability to get out of bed early, older age, and multiple births during maternity. Clinical manifestations include lower extremity pain, pressure, edema, and increased heart rate and respiration.
When sensation is restored to the feet after cesarean section, physical activity should be carried out. 24 hours later, turning and sitting up should be practiced, and getting out of bed slowly. When the catheter is removed, more walking should be done, which not only increases gastrointestinal motility, but also prevents intestinal adhesions and venous thrombosis. Before getting out of bed, you can tie the abdomen with the abdominal belt, so that when you walk around, it will reduce the pain caused by the wound due to vibration.
2. Timely urination and defecation
Purpose: Prevention of urinary tract infection and constipation
Generally, the indwelling catheter will be removed at the end of the intravenous drip on the second day after surgery, and urination should be performed 3 to 4 hours after removal to achieve the purpose of natural flushing of the urinary tract. If you are not used to urinating in bed, you can get out of bed and go to the toilet. If you can’t solve the problem again, you should tell the doctor until you can urinate freely, otherwise it is easy to cause urinary tract infection.
After cesarean delivery, due to the pain of the wound so that the abdomen does not dare to force, urine and stool can not be smoothly excreted, easy to cause urinary retention and constipation, if there are hemorrhoids, the situation will become more serious, so after surgery, the mother should be in accordance with the usual habits of timely urination and defecation.
3. Light diet
Purpose: to avoid vomiting or abdominal distension
In order to avoid choking, vomiting, etc., temporary fasting should be done. If the mother is really thirsty, she can feed a small amount of warm water at certain intervals. Six hours after the operation, you can eat liquid food, such as boiled chicken, duck, fish, bone broth, etc.. A small amount of warm water can be used to moisten the throat before eating, about 50 ml each time. If there is bloating or vomiting, you should get out of bed more often, or use peppermint oil to apply around the belly button. The first meal should be light and simple, such as thin rice and clear soup, and in small amounts. If there is no gastrointestinal discomfort, you can resume your normal diet at the next meal. Breastfeeding mothers can eat more fish soup and drink more water.
Avoid foods that produce gas as much as possible after surgery, and consume other foods in moderation according to personal preference. Avoid greasy and irritating foods and consume more protein, vitamins and minerals to help repair the tissues (e.g. fish, chicken). In addition, take more fiber to promote intestinal motility and prevent constipation.
4. Closely observe the malignant dew
Purpose: to avoid postpartum bleeding
Whether it is natural birth or cesarean delivery, the dew should be closely observed after delivery. If you find that there is a lot of vaginal bleeding or the sanitary pad is wet within 2 hours and exceeds the amount of menstruation, you should notify the health care provider in time.
Under normal circumstances, the malodex will change from dark red to light yellow within 10 days, to white two weeks after delivery, and will stop in 4-6 weeks. If there is still dark red discharge for more than 4 weeks or if the amount of malodex is still a lot two months after delivery, you should go to the hospital for examination. It is important to check if the uterus is not well recovered, or if there is placenta or fetal membranes left in the uterine cavity, or if there is a combined infection.
5. Keep the wound clean
Purpose: To prevent wound infection
Special attention should be paid to abdominal wound healing and care. There are two types of abdominal wounds, straight incision and transverse incision. The second day after delivery, the wound dressing change, check whether there is blood oozing and redness, in general, the wound should be changed twice after surgery, and the stitches removed on the seventh day. If you are an obese patient, or suffer from diabetes, anemia and other diseases that affect wound healing to delay the removal of stitches. After surgery, if the maternal body temperature is high and the wound is painful, the wound should be checked in time, and the redness and swelling can be found by wet dressing with 95% alcohol gauze, twice a day. If there is no improvement after dressing and there is fluctuation in the redness of the wound, it is confirmed that there is infection and the stitches should be removed and drained in time. Special attention should be paid to the condition of the wound if the mother herself has the following infections.
(1) Prolonged labor or water breakage.
(2) Prolonged surgery and heavy intraoperative bleeding.
(3) Poor maternal resistance, such as diabetes or malnutrition.
(4) Pre-existing amniotic chorioamnionitis before cesarean delivery.
(5) Other factors such as ascites, anemia, long-term use of steroids or previous radiation therapy.
In addition, it is important to pay attention to whether the wound is painful when menstruation resumes after delivery, because endometriosis is prone to occur at the wound site, which is manifested by persistent swelling and pain at the wound site during menstruation, or even the appearance of hard lumps. Once such symptoms appear, you should go to the hospital as soon as possible.