Les conséquences d’un accouchement par césarienne? Reviewed by Momizat on . Qu'est-ce qu'une césarienne ? La césarienne est une intervention chirurgicale pratiquée sous anesthésie générale ou locale au cours de laquelle le bébé naît à l Qu'est-ce qu'une césarienne ? La césarienne est une intervention chirurgicale pratiquée sous anesthésie générale ou locale au cours de laquelle le bébé naît à l Rating: 0

Les conséquences d’un accouchement par césarienne?

cessarienneQu’est-ce qu’une césarienne ?

La césarienne est une intervention chirurgicale pratiquée sous anesthésie générale ou locale au cours de laquelle le bébé naît à l’aide d’une incision effectuée dans l’utérus. Elle peut être effectuée en urgence, au cours de l’accouchement, ou programmée à l’avance. Environ 2/3 des césariennes sont programmées avant le travail et 1/3 sont décidées en cours d’accouchement.

Le gyneco-accoucheur effectue une incision dans l’abdomen. Celui-ci rompt ensuite la poche des eaux et fait sortir le liquide amniotique, puis il extrait le bébé. Les suites de l’accouchement par césarienne sont identiques à celles d’un accouchement par voie basse. Une suture de l’incision est effectuée : les points de suture sont retirés aux environs de 10 jours après.

Quand doit-on avoir recours à une césarienne ?

Cette opération est pratiquée dans certaines conditions pour la sécurité de la mère et de l’enfant. Généralement, elle intervient lorsqu’il y a impossibilité d’un accouchement par voie basse, c’est à dire par les voies naturelles :

– en cas de disproportion entre le bassin et la taille de l’enfant : si les dimensions du bassin de la mère sont insuffisantes ou si l’enfant présente un volume trop important, si le bébé se présente en mauvaise   position (présentation du front ou transversale, voire dans certains cas présentation du siège entraînant trop de complications),

– dans le cas d’un enfant prématuré (d’un poids trop faible – hypotrophie), qui souffrirait d’un accouchement par les voies naturelles,

– si le col reste insuffisamment dilaté malgré l’augmentation des contractions et l’emploi de médicaments dilatateurs,

– si la mère présente un fibrome, un kyste ovarien ou un placenta praevia (placenta recouvrant interdisant le passage du foetus par voie basse).

– Si la césarienne a été indiquée pour une cause permanente (comme un bassin trop étroit), alors une nouvelle césarienne sera nécessaire pour un prochain accouchement.

Conséquences possibles d’une césarienne pour la mère

De façon générale, les césariennes se déroulent bien. Cependant, comme toutes les chirurgies, cette intervention peut avoir des conséquences sur le rétablissement de la mère :

– l’allaitement de votre bébé pourrait être une source d’inconfort ou de difficultés car vous aurez une intraveineuse (iv) dans le bras et un ventre douloureux après l’intervention chirurgicale.

– le séjour à l’hôpital sera plus long si vous subissez une césarienne au lieu d’accoucher par voie basse ;

– la douleur et la fatigue sont fréquentes après une césarienne, même après le retour chez vous. Les soins que vous devrez prodiguer à votre bébé pourraient vous sembler plus contraignants. Les mamans qui ont subi une césarienne doivent se reposer, accomplir leurs tâches à leur aise et obtenir de l’aide pour s’occuper du domicile, si possible ;

– La douleur ressentie après une césarienne peut être plus intense et durer plus longtemps que lors d’un accouchement par voie vaginale. Lors d’une césarienne, des médicaments sont prescrits pour soulager la douleur.

– Le risque d’infection à la plaie, dans l’utérus et urinaire si une sonde urinaire a été utilisée est accru. Des antibiotiques sont prescrits pour prévenir ou éliminer l’infection.

– Le risque d’hémorragie et de problèmes de coagulation est accru.

– Les pertes de sang sont plus importantes après une césarienne qu’après un accouchement vaginal, ce qui peut entraîner une carence en fer. Le médecin peut prescrire des comprimés de fer au besoin. Une bonne alimentation pendant la grossesse et après l’accouchement permet à la mère d’avoir de bonnes réserves en fer en vue de la naissance et de refaire ses réserves par la suite.

– les mouvements brusques comme la toux et les éternuements peuvent faire mal à l’abdomen.

– Comme pour toute autre chirurgie, l’anesthésie et la médication contre la douleur peuvent causer de la constipation. Boire régulièrement pour satisfaire la soif et manger des aliments riches en fibres contribue à l’élimination de cet inconfort.

– les besoins d’un tout-petit pourraient vous poser un défi particulier car vous devrez éviter de soulever des charges lourdes pendant quelques semaines.

-La probabilité de revenir à l’hôpital en raison de complications (ex. : hémorragie) est plus grande.

– l’intervention chirurgicale peut vous laisser une cicatrice permanente, mais elle s’atténuera avec le temps.

Yolande Jakin

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