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• Baby will be placed into mothers chest in skin-to-skin contact. • Father can also do skin-to-skin in OR[r]

(1)

Elective c-section Procedure Finland perspective

MHS Nursing Lecturer Perioperative nurse

Katja Varamäki

(2)

Statistics

2

FINLAND 2016

53 614 children born -> 99,7% born alive 99,5% of deliveries in Hospitals

Mean age of all parturients 30,7 years Total c-section rate 16,4%

(5.8% emergency sections)

(3)

Guidelines

3

• Antibiotic prophylaxis 20-60 before incision

• Fathers in OR

• WHO surgical check list

• Delayed cord cut, 60 sec on premature babies

(4)

4

Surgical Team

• Operator, surgeon

• Scrub nurse

• Circulating nurse

• Anesthetist

• Nurse-anesthetist

• Midwife

• (Pediatrician when needed)

(5)

Theatre setup

(6)

Preparations

11 January 2016

• Catheter (short term)

• Diathermy (optional)

• Sterile disposable incision section drapes (energy recycling)

• 3min surgical hand disinfection

• 30º dergee table tilt

• Safety belt over thighs

(7)

11 January 2016

• Skin disinfection 80% etanol + red dye x3

• Spontanius controlled cord traction

• Oxytosin

• Skin closure, single or continious sutures

(8)

Early skin-to-skin contact

11 January 2016

• Right after birth

• After baby’s vitals are checked

• Baby is dryed

• Baby will be placed into mothers chest in skin-to-skin contact

• Father can also skin-to-skin in OR

(9)

Key issues and ongoing challeges in the future

9

• Monitor c-section rates

• Minimize the risk of infections

• Increase safety

(10)

Photo: Brochure Welcome to give birth Tampere university hospital

11 January 2016

(11)

11 January 2016 11

References

National Institute of Health and Welfare

https://thl.fi/en/web/thlfi-en

Salo H Takay A Mäkikallio K 2015 Evidence-based Caesarean Section (published in Finnish)

Duodecim 2015; 131:1137-43

WHO statement on caesarean section rates 2015

http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/

WHO surgical check list http://www.who.int/patientsafety/safesurgery/ss_checklist/en/

https://thl.fi/en/web/thlfi-en http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/ http://www.who.int/patientsafety/safesurgery/ss_checklist/en/

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