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The Need for Caesarian Section - Failures and Successes

Written by Czech Hospital Placements on Sunday, May 1, 2016

Caesarian Section Childbirth The Knick Placenta Previa Blood Types Penicillin Anesthesia

Nowadays, a caesarian section is a daily conducted procedure. On average, one in four births end with a C-section. That makes it currently the most conducted obstetric surgery in gynecology. As future healthcare professionals, it is important for you to know the history of the profession. The Knick series shows us a common historical practice. One of the cases in the series is Placenta Previa. What is that? How to help to the patient? What led to a successful solution?

Placenta Previa is a condition when there is a complication that occurs during the pregnancy and the placenta partially or totally covers the opening of the mother’s cervix. A mother starts to bleed massively and her life, as well as, the life of the fetus, is at risk. The only way to save them is to conduct a caesarean section. A procedure that has been used since ancient times. However, the mother nor the child survived it until 4 important inventions and discoveries:

  1. Implementation of an antiseptic environment in the operation room to decrease the risk of infection. The mortality rate suddenly descended.
  2. Discovery of blood types to ensure secure blood transfusions.
  3. Discovery of Penicillin (antibiotics) that destroy or slow down the growth of bacteria by infections.  
  4. Invention of total anesthesia to conduct the surgery painlessly. Patients in North America were usually etherized and in Europe doctors usually used Chloroform. 

So far, the direct cause of Placenta Previa remains unknown. Yet, as doctor Thackery in The Knick series informs us that the mother had already delivered babies several times without any complication. It is true that a higher amount of births means a higher risk of Placenta Previa. Other risk factors are a previous caesarean section, multipath pregnancy, or higher age.

During the massive bleeding the healthcare professionals tried everything to save the patients’ life. In the series when the mother lost a lot of blood her head was put below the level of her body. Usually this wasn’t a successful precaution for bleeding out. 

Later on (episode 6), doctor Thackery with doctor Chickering come with a new technique – a leather bag filled with water that is inserted into the uterus to slow the bleeding by pressure. It is quite logical, yet obsolete. Doctors tried a lot of methods in the past and this might have been one of them. Pressure on the uterus could help the mother and baby, but still it is only a theory. The vessels are there so small and it is unlikely that it stopped the bleeding completely.

Source: Cinemax

The mortality rate was almost at 100%. Nowadays, it is not even 1% in developed countries. Today, 13 out of 100,000 woman perish, which makes mortality only 0.013%. Yet, the risk is still higher than by vaginal birth, says experts of WHO.  The World Health Organization also warns of the increasing number of childbirth by a caesarian section (Brasilia 54%, USA 33%, and Europe 24%). Mothers to be sometimes  wish to have a caesarian section, even when there is no medical reason, as it is conducted under total anesthesia and it can determine precisely the date of birth. 

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