Vertical vs. Horizontal C-Section

Introduction:

Cesarean section is a surgical procedure that is performed in most of the women in the world. It is a safe procedure and is the alternative option for vaginal delivery. It does not cause risks to the mother and baby. The gynecologist only advises the C-section if the mother cannot do the vaginal delivery. Sometimes, the mother chooses to deliver the baby through C-section. The decision of horizontal or vertical section carries implications for both the mother's and newborn's long-term and short-term health. Several incisions are associated with a high risk of complications such as uterine rupture. The article delves into the characteristics of horizontal and vertical C-sections, their diagnostic factors, surgical techniques, post-operative recovery, and fetal outcomes.

What Is a C-Section?

Cesarean section is also called C-section. It is indicated only when the vaginal delivery is unsafe for both mother and fetus. C-sections can be planned or can be done as an emergency. The emergency C-section is due to complications during labor or delivery. The healthcare provider may cut the stomach and uterus of the mother so that the baby can come out. However, the procedure is performed by injecting anesthesia and in the operating room. These are safe sections that do not harm the mother and the baby. The mother may take a few days to recover and stay hospitalized.

What Is a Vertical C-Section?

The other name for a vertical C-section is a classical C-section. It is a surgical procedure used for the childbirth. The surgeon may cut the uterus and abdomen. The risks and complications of vertical C-sections are more than compared to horizontal C-sections. The overview of the vertical C-section is described below:

• Incision: The surgeon may make a vertical cut along the abdomen's midline. The vertical cut is made from the area below the navel to the pubic bone.

• Surgical Access: The surgery will provide a clear view of the uterus. It is advised in emergency cases or cases of certain complications if there is a need for quick access to the baby.

• Recovery: The recovery of a vertical C-section is more challenging than a horizontal C-section. The recovery time is longer because, in the case of vertical C-sections, the cut is painful and takes more time to heal.

• Scar: The scar in the vertical section is more noticeable than the horizontal section. There can be a risk of keloid formation.

What Is a Horizontal C-Section?

The other name for a horizontal C-section is low-transverse or bikini-cut C-section. It is indicated in cases where the vaginal delivery is unsafe or impossible. The overview of horizontal C-section is described below:

• Patient Preparation: The anesthesia is given to the patient to numb the lower part of the body. The anesthesia is given to reduce the pain during surgical procedures.

• Incision: As the name indicates, the cut is horizontal. The surgeon makes a horizontal cut four to six inches long just above the pubic hairline. The incision area is lower in the case of horizontal as compared to vertical C-section.

• Surgical Access: The surgeon may cut the layers of the skin, such as subcutaneous tissue, skin, and muscle, to see the clear area of the uterus.

• Delivery of the Baby: The baby is delivered through a uterine incision. The surgeon may help remove the baby's head and shoulders from the uterus.

• Placenta Removal: After the baby's delivery, the placenta is carefully removed from the wall of the uterus.

• Closing Incision: The cut is closed with the help of dissolvable sutures. All layers of the skin are closed.

• Recovery: The patient is monitored in the hospital and may spend a few days for care and observation.

What Are the Indications and Contraindications for Horizontal and Vertical C-Section?

The indications and contraindications for horizontal and vertical C-sections are described below:

Indications of Horizontal C-Section:

• If the mother has had a previous horizontal C-section, then it is advisable to prefer and repeat the same C-section to decrease the risk of uterine rupture.

• It is advisable when the position of the baby is in a head-down position.

• Sometimes, the mother chooses a horizontal C-section even if there is no indication for surgery.

Contraindications of Horizontal C-Section:

The horizontal C-section is contraindicated if the woman has a previous vertical C-section. The main risk associated is uterine rupture.

Indications of Vertical C-Section:

• It is performed when the baby is in a transverse or breech position. This type helps in better access to the baby.

• If the woman has had previous abdominal surgeries, accessing the uterus through a horizontal incision is difficult.

• In times of emergency, the vertical incision is performed for quick access to the baby.

Contraindications of Vertical C-Section:

• If the woman has had a previous vertical incision, another vertical incision is not advisable because of the risk of complications.

• The woman has a high risk of uterine rupture or a history of extensive uterine surgeries. Because these surgeries weak the uterine wall.

• If the mother's health is not favorable for a vertical C-section, then it is not advisable surgical procedures.

What Are the Advantages of Horizontal and Vertical C-Section?

The advantages and disadvantages of horizontal and vertical C-sections are as follows:

Advantages of Horizontal C-Section:

• Lower risk of uterine rupture.

• Safer choice.

• Faster recovery.

• Scar formation is low.

• Reduced risk of wound complications such as infections.

Disadvantages of Horizontal C-Section:

• Limited access to the baby.

• In case of maternal health issues or when the baby is in a breech position.

Advantages of Vertical C-Section:

• Better access to baby.

• Quick access during emergencies.

Disadvantages of Vertical C-Section:

• High risk of uterine rupture.

• Slow recovery.

• It's a more noticeable scar.

• Risk of wound complications.

What Are the Risks or Side Effects of Horizontal and Vertical C-Section?

The risks and side effects of horizontal and vertical C-sections are described below:

Risks of Horizontal C-Section:

• Uterine rupture.

• Wound infection.

• Wound dehiscence.

• Adhesion formation.

• Pain and discomfort.

Risks of Vertical C-Section:

• High risk of uterine rupture.

• Longer recovery.

• More noticeable scar.

• Wound complications.

• Adhesion formation.

• Risk to future pregnancies.

Conclusion:

In conclusion, horizontal and vertical C-sections are safe and effective surgical procedures for childbirth. The healthcare professionals will do this surgery if the baby is in a breech position. It does not cause any harm to the mother and the fetus. Each incision type has its advantages and disadvantages. Patients are encouraged to discuss their concerns and preferences with the healthcare provider for decision-making regarding cesarean or vaginal delivery.