General Surgical Considerations
- Fetal delivery should be fast as there is a theoretical risk of fetal bleeding
- A low transverse hysterotomy can theoretically cause fetal bleeding if the placenta is implanted anteriorly, however a classical incision or high transverse can increase maternal bleeding and morbidity in subsequent pregnancies.
- Practically, a lower segment hysterotomy is still performed with the plane found between placenta and uterus, and fetus extracted.
Clinical Pearl
The most important thing is to deliver the fetus quickly! Generally in this situation, delayed cord clamping is not done because the placenta is disrupted. Also, no delayed cord clamping if an abruption is suspected.