Definition. Obstetric surgery is actions of a physician aiming to eliminate the danger to the life and health of a parturient woman and/or fetus, which can be eliminated or reduced only by surgical intervention.
Classification of obstetric surgeries:
1. Surgeries aimed at pregnancy preservation in cervical incompetence (CI).
2. Surgeries for pregnancy termination (artificial abortion) at an early and late gestational age.
3. Surgeries correcting fetal position.
4. Maneuvers for breech extraction (extraction by foot, two feet, by groin traction).
5. Bringing down the foot in breech presentation.
6. Assisted delivery:
► application of obstetrical forceps (outlet, mid-cavity);
► vacuum extraction of fetus;
► cesarean section.
7. Embryotomy.
8. Surgeries in placental and early postpartum period.
9. Surgical methods of managing obstetrical hemorrhage.
10. Minor obstetric surgeries in delivery.
Preparation for obstetric surgery. The presence of indications for surgery does not mean that in all cases it a good outcome is warranted. First of all, it is necessary to determine the prerequisites that ensure the maximal potential safety of the surgery and be aware of contraindications to it. For this, one should be guided by maternal and fetal interests. However, in cases when maternal life and health are in greater danger than that of the fetus, the issue is decided in favor of the mother. In doing so, the outcomes of surgery are determined both based on immediate outcomes and on long-term consequences. The strategy of modern obstetrics is often organ-preserving surgery. The obstetrician should be sure that surgery at this time is not more dangerous than further conservative follow-up and expectation. Before obstetric surgeries which are most often accompanied by blood loss, it is necessary to obtain data on complete blood count, urinalysis, ECG, coagulogram, information about allergic reactions and intolerance to some drugs. Any obstetric hospital should be absolutley prepared to manage a potential bleeding.