C-sections for premies

  1. Had a 29 weeker delivered by C-section. At first, I thought it was odd. Then, my coworker explained that they find it is less stressful for the infant. Makes sense to me. Is this the norm now?
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  2. 10 Comments

  3. by   webbiedebbie
    Oh, by the way, mom and baby are doing fine.
  4. by   Jolie
    This is not a new practice, maybe just a rare instance of it being put to use. A study was published about 8 or 9 years ago clearly defining the benefits of decreased trauma and fewer intracranial bleeds in preemies delivered by C-section. Unfortunately, not many OB's do elective C-sections for preemies, although I'm not sure why. Perhaps they are not aware of the study, or do not believe in subjecting mom to the added risk of an operative delivery in cases where the baby's ultimate survival is questionable. I'd be interested in hearing what other nurses see in their practices.
  5. by   Vsummer1
    Just a student's understanding of this: If the infant needs to be removed from the intrauterine environment than the c-section would be warranted. You would have to soften up the cervix, then dose with oxytocin to start the birth process. This could take time along with possibly having hyperstimulation of the uterine contractions and bring stress to the baby. It is the age of the fetus / baby and why it needs to be removed at that early of a date. Any stress of navigating the birth canal and enduring contractions would be eliminated with a c-section, affording the baby a (possibly) better outcome.

    Does this sound right?
  6. by   mark_LD_RN
    the main reason it is done is decreased birth trauma premies are real susceptable to intercrainial bleeds. I have also seen docs use forceps to protect the head of a premie during a vaginal birth.
  7. by   canoehead
    Forceps to PROTECT the head? Sounds like an oxymoron to me, but perhaps the docs I work with are not as skilled with the forceps.
  8. by   HazeK
    Originally posted by canoehead
    Forceps to PROTECT the head? Sounds like an oxymoron to me, but perhaps the docs I work with are not as skilled with the forceps.
    Yep, to actually protect the baby!

    I wish I could remember the "pounds per sq inch" of pressure that typical vaginal vault excerts on a fetal head, but it was a jaw-dropping number! A physician WHO IS SKILLED in forceps' use, can indeed protect the fetal head from the surrounding tissues. The forceps are not used hardly at all for traction, leaving the mother to still push out the baby, as much as to guide the fetal head under the symphisis and out..

    Less IC bleeds!

    Hugs
    Haze
  9. by   NicuGal
    Actually, they have determined that if the baby is in good position, not breech or sidelying, then vaginal is the way to go. Even the kids with open gut problems are delivered vaginally if able. Do the vag vs c/s kids do better....a preemie is a preemie..if the lungs are good to go, so is the baby. Why give them the anesthesia if they don't need it. Also, we haven't seen an increase in IVH's with vaginal births. And I have NEVER seen an OB use forceps or vacuum on a preemie....right there is asking for trouble. Most IVH's aren't caused by birth trauma but by fluctuating BP's and physiological changes in the baby.
  10. by   mark_LD_RN
    well said hazeK-- they use the forceps just to protect the head no traction at all is applied.but it takes skill. vaccum is never used on premies !as matter of fact our protocol says 34 weeks or less do not use vaccum
  11. by   mother/babyRN
    If it is an emergent thing, thats also the quickest way to do it...More details?
  12. by   dawngloves
    Only do preemie c/s on eclamptic moms, poor fetal tracings, certain anomolies. I haven't really noticed a correlation between SVD and IVH or even hyperbili for that matter. I'd think the rational is that every minute in utero helps or it's a better transition?

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