Scheduling+Cesarean+Section

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 * Scheduled Cesarean Births**
 * Cesarean births are usually scheduled on the Perinatal Unit Monday through Friday mornings by calling 925-370-560
 * When scheduling, accurate gestational age dating is essential
 * Cesareans will not be performed before 39w0d unless there is a medical or obstetric reason indicating earlier delivery

Please refer to the following guideline when trying to determine patient due date: Use ultrasound over sure LMP if difference is: > 5 days before 9 wk gestation > 7 days from 9w0d - 15w6d gestation > 10 days from 16w0d - 21w6d gestation > 14 days from 22w0d -27w6d gestation > 21 days after 28w0d gestation

Medical/Obstetrical indications - prior uterine scar: C/S, myomectomy, hx uterine rupture, - placental problem: previa, accreta, - malpresentation: breech, transverse, twin A breech - HIV+ with Viral load > 1000 copies/mL
 * Indication for C/S:**

In the absence of maternal or fetal indications for cesarean, a vaginal delivery is safe and appropriate and should be recommended. Please discuss any requests for primary cesarean without usual indication with an OB Dept member.

Planned term cesarean delivery should be scheduled for > 39w0d of gestation Conditions requiring cesarean delivery < 39w0d - usually do not require amniocentesis. The goal is to deliver prior to onset of labor: - For prior classical, T, or J incision ( with involvement of upper uterine segment) planned delivery: 36w0d - 37w6d - For prior myomectomy planned delivery: 37w0d - 38w6d - For prior uterine rupture planned delivery: 36w0d - 37w6d - For suspected placenta accreta planned delivery: 34w0d (hopefully at Alta Bate - not at CCCRMC) -For placenta previa: planned delivery 36w0d -37w6d
 * Timing**

Call L/D to schedule date and time L/D phone (925) 370 – 5608 and ask to schedule cesarean Ask the scheduling nurse for appt for pre-op teaching in the antepartum testing prior to the cesarean---this can also be scheduled directly with antepartum testing in Martinez Make sure 30 days sterilization PM330 form is correctly and appropriately filled-out and signed and dated by the patient and the provider Patient should be NPO after midnight the night before scheduled C/S Instruction sheet for cesarean available on star icon forms under OBGYN instructions
 * Details**