Monitors During a C-Section

This is one of those little details that you may not think about too much but can give you a better picture of what to expect when it’s time to go into the operating room for your c-section.

 

During the surgery, the anesthesiologist’s job will be to watch your vital signs – your heart rate, your blood pressure, and your oxygenation – to assure your body is functioning normally and look for any abnormalities that could signal a problem.  For every surgery we have a set of standard monitors.  Meaning, we use these for everyone no matter how big or small the procedure is.  I’ll go through these one by one and give you some tips along the way. 

 

#1 Blood pressure cuff

 

A blood pressure cuff will be placed on your arm to monitor your blood pressure (BP).  The cuff is automated, so we just press a button on our monitoring screen to start the measurement.  The cuff will inflate then slowly deflate to determine the BP.  The accuracy of the measurement is dependent upon the cuff being the appropriate size – that is the right width and length based on the size of your arm.

 

The blood pressure cuff can be placed on your ankle instead of your arm if needed, but the measurement will be slightly different. (1)  If you have significant shivering, the movement of your arm may make it impossible to get accurate measurements, and in that case the leg can be used. 

 

TIP :  The first time the blood pressure cuff goes off, it may squeeze your arm pretty tightly, as it gets a sense for how much it will have to squeeze every subsequent time.  Especially the first time its checking your BP, you want to keep your arm straight and not move it– or as I say “don’t fight it! It will just squeeze you back harder”.  If the squeezing is really bothering you or pinching your skin in any way, ask your team to reposition it. 

 

Your blood pressure will be checked at least every 5 minutes – that’s the standard - but some anesthesiologists might want to check it more frequently, particularly if your BP is a bit on the high or low side.  If that is the case, we can use medication to get your BP back in the normal range.  The blood pressure cuff is placed on the arm which does NOT have your I.V. so that it does not interfere with the flow of your IV fluids. 

 

You can still hold your baby after delivery with the blood pressure cuff on your arm.  But, if the position of your arm is affecting the measurement, you may be asked to keep your arm straight and still for a moment to get a reading.

 

#2 Pulse Oximeter

 

A pulse oximeter is a sticker or clip which usually goes onto the tip of your finger and helps us determine how much oxygen is circulating in your blood.  This should stay on at all times during the surgery and the measurement we get is called “continuous pulse oximetry”.  Most of the time the clip is placed on your finger and any finger will do.  The clip can also be placed on your toe or your ear.  It works by shining a light from one side of the clip to the other, so it is possible for dark nail polish to affect the reading.  For fingers I prefer the ring finger, so it doesn’t interfere as much with those first newborn touches.  Squeezing of the blood pressure cuff can also interfere with this measurement so it’s usually placed on the arm opposite the blood pressure cuff (the same arm as your IV).

 

#3 Electrocardiogram (EKG or ECG)

 

The EKG monitor gives us information about the electrical activity of your heart and how fast its beating.  Electrodes (basically little stickers) are placed in particular places on your chest in order to get this information.  Either 3 or 5 electrodes will be used.

 

TIP: Ask if the electrodes can be placed away from your breast area - toward your shoulders/back and under your breasts.  This way they will not interfere with skin-to-skin after delivery.

 

#4 Temperature monitoring

 

You will have your temperature checked before and after surgery.  Sometimes, your temperature can be monitored during the surgery with a sticker on your forehead or using a special bladder catheter that is specifically designed to continuously monitor your core temperature.  This is important because the anesthesia and IV fluids can lower your body temperature even if you don’t feel cold.