An unscheduled caesarean requires flawless organization and precise gestures. Thanks to a color code transmitted to the medical team, everyone knows how to react and organize themselves for the success of the intervention.
Sometimes the delivery doesn’t go as planned. The expecting mom came for a simple check-up and learned that she would have to stay to give birth quickly. Other times, vaginal birth has started, but an unforeseeable complication forces the medical team to perform a cesarean section to preserve the health of the mother and baby. These moments when everything changes are always very distressing for future parents and the medical team has little time to give long explanations and to reassure. However, urgency does not mean rushing. On the contrary!
Like the traffic lights, emergency cesarean sections are classified and then performed according to three color codes which each have their meaning. “These codes were created to try to give an emergency grade to unscheduled cesareans. They allow the teams to organize themselves according to the urgency. Across many countries in Europe, three levels have been defined: green, orange and red.
Code Green Cesarean: no major alert
No major alert, but a caesarean is expected within the hour if the situation does not change. The team (anesthesiologist, obstetrician, midwives, nurses, pediatrician) therefore has time to prepare and go to fetch the future mother in the delivery room to take her to the operating room. “This is the most common code. Obstetricians trigger this code when the baby has a heartbeat with little abnormality, has trouble getting down into the pelvis, and the cervix has trouble expanding.
Cesarean section Orange: when you shouldn’t delay
The baby’s heart rate, monitored by monitoring, is a little too slow, fluctuating or irregular. We cannot take the risk of letting anoxia (lack of oxygen) or a heart rhythm disorder take hold, but neither the life of the mother nor of her baby is in immediate danger. The team has half an hour to start the cesarean. As with green cesareans, we can therefore favor locoregional anesthesia as an epidural (if the mother already had it) or a spinal anesthesia (anesthesia simpler and faster than the epidural).
Code Red Cesarean: to be performed urgently
The urgency is maximum, the life of the mother or / and the child is at stake, it is necessary to intervene as quickly as possible and to give birth to the baby in less than 20 minutes. Main causes: a complication in the mother during childbirth (uterine rupture, hemorrhage), the baby’s heart rate too slow (60 to 80 beats per minute instead of 130 to 150) for more than 5 minutes, or even damage of the umbilical cord (descent of the umbilical cord before the fetus during childbirth) which is compressed and no longer supplies the baby with oxygen. This concerns approximately 2% of deliveries. “If the epidural is already in place (80% in France), we use it immediately to inject a stronger product that works faster. Otherwise, it is general anesthesia, faster but more difficult to manage than locoregional anesthesia. Every minute is precious. We can do Cesarean sections in 10 to 12 minutes if the organization is well established and if the teams are trained in this type of situation.
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