URGENT CAESAREAN SECTION COUNSELING. PROBLEMATIC QUESTIONS AND WAYS OF OPTIMIZATION
Obstetric problems that arise during urgent operational labour, perinatal consequences, psychological component, reproductive perspectives, cosmetology moments are the incomplete list of questions faced by a physician and a patient in case of an urgent caesarean section. The goal is to analyze clinical, perinatal results, psychological component of urgent operational labour by means of CS from the position of categories of urgency to optimize counseling the patients before an emergency surgery. The analysis of cases of abdominal birth of 1st , 2nd and 3rd categories of urgency during the first half of the year 2017 in the Department of Pregnancy Failure of the Lviv Regional Clinical Hospital has been carried out. 97 case histories of childbirth are presented and analyzed, and the labour has been carried out urgently. The age of women at labour ranged from 18 to 36 years. CS of the incomplete pregnancy was carried out in 59 (60.8%) cases and with 38 patients in the full-term pregnancy. Caesarean section of the first category of urgency was carried out with 44 patients (45.4%), the second one with 31 (31.9%), and the 3rd with 22 (22.7%). A retrospective analysis of childbirth histories in case of an urgent CS confirmed the already existing trends and problems of operative obstetrics, as well as showed some practical possibilities, and mostly, their lack in terms of patients being informed and counseled before the CS surgery. Consultation of a pregnant woman before surgery is carried out by an obstetrician-gynecologist, an anesthetist and a neonatologist. The patient gets acquainted with details and being informed gives a written consent to medical intervention by signing two documents for the obstetrician-gynecologist, one for an anesthetist, and this is the minimum package of medical documentation in terms of legal norms. It is also necessary to take into account the psychological state of a woman: awareness of a threatening condition for herself or the child; labour stress, pain, emotional stress, physical exhaustion. On such a ground the counseling of a pregnant woman should be concise, correct, confident, and rational. Thus, therefore, counseling the patients before the operation of the CS cannot be considered standard. The categories of urgency of medical interventions include a varied approach to a specific obstetric situation, the individual selection of information for the patient and her family, the optimal use of the time interval for preparation for the surgery and delivery of information.
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