Maternal request CS

Question 1

What impact does elective CS have on risk of pelvic floor damage/urinary incontinence?

Answer 1

• pre labour elective CS does confer benefit
• however this benefit reduces with age and parity regardless of MOD
• CS may reduce risk of pelvic floor damage and prolapse however CS not indicated on this basis alone
• in women who have exclusively had CS the rate of UUI the same in age matched peers

Question 2

List 4 evidence based measures to approaching CS?

Answer 2

• antibiotics pre op
• vaginal cleansing
• IDC
• Skin prep

Question 3

List 3 Pre op measures that aim to reduce infection following CS

Answer 3

• antibiotics - pre skin incision RR of 0.5 when cf after skin incision
• skin prep with Chlorhex cf iodine, Reduced incidence of surgical site infection when cf iodine use RR 0.72
• pre op vaginal cleansing with iodine, reduces endometritis RR of .41