Problem:
Patient Summary: A 32-year-old female (G3, P2) at 39 weeks' gestation underwent an elective repeat lower segment cesarean section (LSCS) with a bilateral tubal ligation for sterilization. Key Details: Indications for Surgery: Term pregnancy (39 weeks) History of previous cesarean section Patient's choice not to have a trial of labor (TOLAC) Request for permanent sterilization Procedure: Cesarean Section: An uncomplicated LSCS was performed via the existing Pfannenstiel incision. A healthy female infant (birth weight 3960 g) was delivered who cried spontaneously and required no resuscitation. Tubal Ligation: A Pomeroy procedure was performed, involving the resection of approximately 2.5 cm segments from the mid-portion of both fallopian tubes. Anesthesia: Spinal Outcomes: Mother: Tolerated the procedure well. Estimated blood loss was 500 mL. Her post-operative course was uncomplicated. Newborn: Apgar scores were normal. Cord blood gas showed a mild metabolic acidosis (pH 7.20, Base Excess -4). Pathology: The resected fallopian tube segments were confirmed by histology to be unremarkable. Discharge: The patient was discharged on post-operative day #1 with instructions for pain management (Tylenol #3) and stool softeners (Colace). Follow-up was scheduled for the baby at 1 week and for the mother for a postpartum check at 6 weeks. Final Diagnoses: Pregnancy at 39 weeks' gestation Previous cesarean section Elective sterilization Status-post uncomplicated repeat cesarean section and bilateral tubal ligation In short: This was a planned, routine repeat C-section. Need Assignment Help?