Came home from a placental abruption resulting in a horrifying emergency c section and 2 week hospital stay and made a bad choice to watch House of the Dragon where cesareans are a death sentence. I did a bit of research and found out medieval c sections did happen but were only performed if the mother was dying anyway as it was always fatal. I understand that infection would’ve killed any surviving women back then but apparently they died during the operation anyway. So I’m confused about what killed women during the procedure it’s self? As far as I’m aware I did not receive a blood transfusion so it can’t have been blood loss which would’ve been my guess pre my own experience. Did they not have the medical tools necessary to put those women back together afterwards eg stitches? Or did they not know how to make insicions in a non fatal way?
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Obgyn here. Deadliest part of c-section is blood loss. There are lots of ways to control blood loss, but it is normal to lose up to 20% of your total blood volume, even today. No need to transfuse unless it’s greater than that or severely anemic afterward. An abruption increases blood loss for sure, but if the surgery is done quickly then you may not need a transfusion. Especially if your starting hemoglobin is adequate.
Back then they didn’t have the tools to control blood loss. Absorbable suture wasn’t invented until the late 1800s and the non-absorbable stuff like metal wires which they used back the are not adequate at control bleeding from the uterus, and they have used some rudimentary cautery (ie branding tools), but clearly that’s not a good way to control bleeding.
Other things like infection, operative risks (ie stroke, MI, DVT/PE), post op complications (hematoma, abscess, unrecognized visceral injury or ongoing bleeding) are also very likely to cause mortality. These we can monitor for now with advanced imaging and labs… physical exam is just not adequate enough.
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