Emergency cs question

[neonalee]

When I had my emergency cs 2 years ago I did not have an epidural & was told because of that I had to have general anesthesia. Today I've read several stories about planned cs where the epidural was put in when they got to the OR & it didn't sound like much time before the procedure was started.

Why is GA necessary for an unplanned cs if you don't have an epidural? DS was not in distress for mine. I had been in labor 34 hours & wasn't progressing at all.

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[katelove]

An epidural can be put in prior to an emergency c/s if it is thought that mum and baby are well enough to wait the extra time. And as long as there are no contraindications of course.

It's only when things are very time critical that a GA needs to be used as it can be done in a few minutes whereas an epidural will usually take about 20 minutes from start to ready to cut, if all goes well.

[MeepyCat]

This is why I wish OBs and midwives would routinely sit down with patients and debrief on the events and decisions involved in a labor. The only way to know for sure would be to ask the doc who did the surgery, or to get the complete medical records with all the notes.

There are sometimes contraindications for epidural, like low blood pressure.

[neonalee]

That is really good to know thanks!

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[berrymama]

You state that you had an emergency cs, but that your baby was not in distress. Why then was it an emergency cs? Or was it an urgent cs (done within 30 minutes of decision time)? For a true emergency and/or crash cs, yes, GA is generally used if there is no epidural because they do not want to delay getting the baby out. But if there is no fetal distress, a spinal would usually be placed.

[katelove]

Originally Posted by berrymama 

You state that you had an emergency cs, but that your baby was not in distress. Why then was it an emergency cs? Or was it an urgent cs (done within 30 minutes of decision time)? For a true emergency and/or crash cs, yes, GA is generally used if there is no epidural because they do not want to delay getting the baby out. But if there is no fetal distress, a spinal would usually be placed.

Emergency c/s just means that it wasn't booked in advance, it isn't a reflection of the condition of mother or baby.

[berrymama]

Originally Posted by katelove 


Emergency c/s just means that it wasn't booked in advance, it isn't a reflection of the condition of mother or baby.

Where I work as a L&D RN, an emergency cs reflects a medical emergency (for either mom or baby) and is performed ASAP (may or may not have time to place a spinal).

An urgent section is done within 30 minutes of decision time (such as for worsening tracing that is not yet emergent, breech in active labor)

A non-urgent/unscheduled section is done in cases of non-progressing labor/descent, repeat cs (if mom that was planning on a repeat cs comes in with SROM or in laobr), or breech (not in active labor).

[neonalee]

Thanks for the additional replies. Honestly I don't really remember much of it, just snapshots. Eventually I will request the records & read them but I'm not ready yet.

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[Caracol8]

I had also been in labor for 34 hours when we decided on a c/s.  In our case it was a non-emergency c/s because my baby was stuck but not in distress.  They gave me a "spinal anesthesia" which is different than an epidural: it doesn't require a catheter and its effects come quicker but last for a shorter span of time.  They would've given me the general if the spinal hadn't worked.  I bet those stories you read were referring to spinals right before surgery, not epidurals (in the strict definition).