excessive uterine contractions
Introduction
Brief introduction of uterine contraction Productivity includes uterine contractility, abdominal wall muscle and diaphragm contraction, and levator ani contractility, with uterine contractility. During childbirth, the rhythm, symmetry, and polarity of the uterus contraction are abnormal or the intensity and frequency are changed, which is called abnormal uterine contractility. Clinically, due to abnormal birth canal or fetal factors, obstructive dystocia is formed, which increases the resistance of the fetus through the birth canal, resulting in secondary productivity abnormalities. Abnormal uterine contractility is clinically divided into two types: uterine contraction and uterine contraction. Each category is divided into coordinated uterine contractions and inconsistent uterine contractions. Hypertension of uterus refers to the rhythm, symmetry and polarity of uterine contractions. All are normal, only the uterine contraction force is too strong. basic knowledge The proportion of illness: 0.03% Susceptible population: pregnant women Mode of infection: non-infectious Complications: calving infection postpartum hemorrhage neonatal intracranial hemorrhage
Cause
Uterine contraction
(1) Coordinating uterine contraction is too strong
The rhythm of uterine contraction, symmetry and polarity are normal, only the uterus contraction force is too strong, too frequent, if the birth canal has no resistance, the cervix is quickly opened in a short time, the delivery ends in a short time, the total labor is less than 3 hours It is called emergency production and is more common in women.
Influence on mother and child
(1) The effect on the mother: the contraction is too strong and too frequent, the labor process is too fast, can cause primipara cervix, vaginal and perineal laceration, when the delivery is too late to disinfect, it can cause puerperal infection, postpartum uterine muscle fiber shrinkage is easy Placental retention or postpartum hemorrhage.
(2) The impact on the fetus and newborn: excessive contraction of the uterus affects the blood circulation of the uterus placenta, the fetus is hypoxic in the uterus, prone to fetal distress, neonatal asphyxia or even death, the fetus is delivered too fast, the fetal head is The pressure in the birth canal is suddenly relieved, which can cause intracranial hemorrhage in the newborn. It is too late to receive the product. The newborn is prone to infection. If it falls, it can cause fracture and trauma.
(B) uncoordinated uterine contraction is too strong
1. Ankylosing uterine contraction Ankylosing uterine contraction is not an abnormal function of uterine muscle tissue, which is almost caused by abnormal external factors, such as obstruction due to childbirth after labor, or inappropriate application of oxytocin, or placental abruption of blood infiltrating uterus Muscle layer can cause tonic contraction of the myometrium above the internal cervix, maternal irritability, persistent abdominal pain, refusal to press, fetal position unclear, fetal heart can not hear clearly, sometimes pathological reduction Ring, hematuria and other signs of uterine rupture.
2, uterine stenosis ring (constriction ring) a certain part of the muscle wall of the uterine wall is a ring-shaped stenosis formed by spasmous inconsistent contraction, which does not relax, called the uterine stenosis ring, mostly at the junction of the upper and lower uterus. It can also be found in a narrow part of the carcass, at the neck and at the waist.
Due to nervousness, excessive fatigue and improper application of uterine contractions or rough obstetric treatment, maternal persistent abdominal pain, irritability, slow cervical dilatation, stagnation of the first exposed part of the fetus, slow and slow fetal heart rate The vaginal examination can reach the narrow ring, which is characterized by the fact that the ring does not rise with the contraction, which is different from the pathological contraction ring.
Prevention
Uterine contraction prevention
1. Strengthen pregnancy care.
2. Actively treat malnutrition and chronic diseases, and timely detect and correct fetal position errors.
3. Strengthen the monitoring of birth time, provide a comfortable environment, give psychological support, and eliminate ideological concerns and fear.
4. Care for maternal rest, diet, bowel movements, avoid excessive use of sedative drugs, and timely detect and deal with dystocia factors.
5. Prevention of harm caused by excessive contractions. Pregnant women with emergency births are hospitalized 2 weeks in advance, do not leave the ward during hospitalization, and cooperate with pregnant women to explain the hazards of emergency.
6. Prepare for the delivery of newborns and rescue newborns early.
7. Prevention of postpartum hemorrhage and postpartum infection.
Complication
Hyperentretic uterine contraction Complications, postpartum hemorrhage, neonatal intracranial hemorrhage
The contraction is too strong and too frequent, the labor process is too fast, can cause primipara cervix, vaginal and perineal laceration, when the delivery is too late to disinfect can cause puerperal infection, postpartum uterine muscle fiber shrinkage is prone to placental retention or postpartum hemorrhage.
The baby is delivered too fast, the pressure on the fetal head in the birth canal is suddenly relieved, which can cause intracranial hemorrhage in the newborn. It is too late to receive the product. The newborn is prone to infection. If the ground falls, it can cause fracture, trauma, postpartum uterine muscle fiber shrinkage and prone to placenta. Detention or postpartum hemorrhage.
Symptom
Symptoms of uterine contraction too strong Common symptoms Tension and abdominal pain irritability uterine stenosis stenosis ring pseudo-augmentation uterus rupture uterine bleeding after artificial abortion postpartum pregnancy mid-abdominal abdominal pain fetal heart irregular
(1) Coordinating uterine contraction is too strong: the rhythm of uterine contraction, symmetry and polarity are normal, only the uterus contraction force is too strong, too frequent, if the birth canal has no resistance, the cervix is quickly opened in a short time, childbirth in In a short period of time, the total labor is less than 3 hours, called emergency production, more common in women.
(B) uncoordinated uterine contraction is too strong
Tonic uterine contraction
Ankylosing uterine contraction is not an abnormal function of uterine muscle tissue, which is almost caused by abnormal external factors. For example, obstruction due to childbirth after labor, or inappropriate application of oxytocin, or placental abruption of blood into the myometrium can cause The myometrium above the internal cervix has a tonic contraction, maternal irritability, persistent abdominal pain, refusal to press, the fetal position is unclear, the fetal heart can not be heard clearly, and sometimes the pathological contraction ring, hematuria and other uterus Sign of rupture.
2. uterine stenosis ring (constriction ring)
The muscle of a certain part of the uterine wall is a ring-shaped stenosis formed by the inconsistent contraction of the uterus. It is called a uterine stenosis ring, mostly at the junction of the upper and lower uterus, or in a narrow part of the carcass. The neck is common at the waist.
Due to nervousness, excessive fatigue and improper application of uterine contractions or rough obstetric treatment, maternal persistent abdominal pain, irritability, slow cervical dilatation, stagnation of the first exposed part of the fetus, slow and slow fetal heart rate The vaginal examination can reach the narrow ring, which is characterized by the fact that the ring does not rise with the contraction, which is different from the pathological contraction ring.
Examine
Excessive uterine contraction
For routine obstetrics and gynaecology examinations, vaginal examinations can reach the narrow ring of harder and elastic parts.
Diagnosis
Diagnosis of uterine contraction
diagnosis
1, often occurs in the application of oxytocin or obstructive dystocia.
2, the contraction lasts for a long time, intermittent time is short or no interval, spontaneously complained of abdominal pain.
3, check the palace body strongly contracted into a plate-like hard, fetal distress, such as the appearance of pathological shrinkage ring, and rise, both for the first to find uterine rupture.
Differential diagnosis
A small number of fetuses are small, the pelvic floor is loose, and the maternal birth canal is easy to expand and cause acute labor. Such productivity is not necessarily too strong and should be identified.
