birth control surgery complications
Introduction
Introduction to complications of birth control surgery The complications of birth control surgery mainly include organ damage caused by uterine perforation or rupture due to birth control, cervical, vaginal laceration, attachment, bladder, intestinal and mesenteric injuries, resulting in bleeding or need to be repaired or removed. basic knowledge Sickness ratio: 0.02%-0.04% Susceptible people: women Mode of infection: non-infectious Complications: chronic pelvic inflammatory disease, intrauterine adhesions, incisional hernia, ectopic pregnancy
Cause
Causes of complications in birth control surgery
Cause (85%):
Bleeding and hematoma have no bleeding-prone disease, cause external bleeding due to birth control surgery (100 ml when putting and taking intrauterine device, 200 ml when early pregnancy induced abortion or uterine forceps, medium-term pregnancy artificial Abortion includes uterine forceps and various types of bleeding during the induction of labor or 24 hours after delivery (300 ml) or internal bleeding and abdominal wall hematoma, broad ligament hematoma and retroperitoneal hematoma. There was no systemic or local infection before the infection. Within 2 weeks after birth control, the abdominal wall incision, peritoneum, uterus, appendage and pelvic inflammation directly related to birth control surgery began to appear, and even developed into systemic infection.
Prevention
Prevention of complications in birth control surgery
1. Before the operation, you should carefully carry out physical examination and necessary auxiliary examinations, and strictly follow the "conventional surgery routine" to eliminate the contraindications of birth control surgery and master the indications. And do a good job of the subject's ideological guidance and related knowledge.
2, the operation should be strict aseptic concept, to avoid infection, surgical operations should be careful, light, complete hemostasis, accurate, especially to prevent organ damage and foreign bodies.
3, after the surgery according to the Ministry of Health of the People's Republic of China, the National Family Planning Commission on the "various birth control surgery" recommendations, the appropriate rest of the subject, and regular follow-up, find problems in a timely manner, do a good job.
Complication
Birth control complications complications Complications chronic pelvic inflammatory disease intrauterine adhesions incision ectopic pregnancy
I. Idiom ectopic
The intrauterine device is partially or completely clamped into the myometrium, or is located outside the uterus, including the pelvic cavity, the abdominal cavity, the broad ligament, and the abdominal cavity.
Second, the IUD breaks and deforms
Patients with obvious clinical symptoms due to rupture and deformation of the intrauterine device, including dislocation at the joint.
Third, chronic pelvic inflammatory disease
There was no genital inflammation before surgery. In the short term (starting within two weeks), there was an acute pelvic infection directly related to birth control surgery. The symptoms were persistent or the condition was recurrent due to incomplete treatment. There were positive signs in gynecological examination. .
Fourth, pelvic congestion
Lower abdominal pain after tubal birth control, aggravation of symptoms in long-term or sexual life, no significant positive findings in vaginal examination, pelvic venography, laparoscopic or surgical confirmation of pelvic varices, and exclusion of other genital organic diseases.
Fifth, cervical or intrauterine adhesions
Due to abortion or incomplete flow, periodic abdominal pain after uterine aspiration and scraping, uterine hemorrhage, significant reduction in menstrual flow or amenorrhea, and cervical canal, uterine cavity exploration, x-ray angiography or hysteroscopy Check the verifier.
Sixth, intestinal adhesions before and after abdominal sterilization, no history of abdominal surgery, no peritoneum, abdominal visceral inflammation, there is no inflammation or adhesion in the abdominal cavity during sterilization, typical incomplete or complete intestinal obstruction after surgery Symptoms, confirmed by x-ray examination or laparoscopic examination, laparotomy revealed intestinal adhesions.
Seven, omental syndrome
There was no inflammation or adhesion in the abdominal cavity during abdominal sterilization. Postoperative nausea, vomiting, discomfort under the xiphoid, torso could not be straightened, and there was a fixed point of pain during standing. The omentum and abdominal cavity were confirmed by laparoscopy or laparotomy. Or there is adhesion in the pelvic cavity.
Eight, after the birth control surgery, incisional hernia, chronic inflammatory mass or abdominal wall fistula, etc., the abdominal wall endometriosis caused by curettage, and the pelvic uterus centered on the fallopian tube stump caused by human flow and sterilization Ectopic pregnancy occurs after endometriosis and tubal ligation.
Nine, various complications caused by the treatment of complications of birth control surgery.
Symptom
Symptoms of birth control complications Common symptoms Traumatic intrauterine adhesions Uterine perforation bleeding tends surgical trauma
First, organ damage
Perforation or rupture of the uterus due to birth control surgery, cervical, vaginal laceration, attachment, intestinal and mesenteric injuries, resulting in bleeding requiring repair or removal.
Second, bleeding and hematoma
No bleeding-prone disease, external bleeding caused by birth control surgery (100ml when taking intrauterine device, 200ml when early pregnancy induced abortion or uterine forceps), abortion of mid-term pregnancy including uterine forceps And a variety of induction or 24 hours postpartum bleeding volume 300ml) or internal bleeding and abdominal wall hematoma, broad ligament hematoma and retroperitoneal hematoma.
Third, infection
There were no systemic or local infections before surgery. Intra-abdominal incision, peritoneal, uterus, appendage and pelvic inflammation, which developed directly into systemic infection, began within two weeks after birth control.
Fourth, the flow of people is incomplete
Aspiration flow, uterine forceps and various vaginal persistent or repeated bleeding after induction of labor, effluent or uterus scraping is embryo, fluff or placenta organizer. If necessary, it should be confirmed by pathological examination.
Five, the flow of people failed, continue pregnancy
It refers to those who continue to give birth without absorbing or not scraping the embryo when they are sucking a uterus or uterine forceps.
Sixth, amniotic fluid embolism
In the process of induced abortion (including uterine forceps, various induction or curettage), a series of symptoms and signs such as pulmonary embolism, shock, coagulation mechanism, acute heart and kidney failure, etc. due to amniotic fluid entering the blood circulation.
Seven, gas embolism
In the case of abortion or hysteroscopic or laparoscopic surgery related to birth control, gas is plugged into the blood vessel due to instrument malfunction or operational error.
Eight, drug corrosion injury
When the tubal drug is blocked, the corrosive drugs accidentally injure other tissues and cause symptoms, and those with physical symptoms.
Examine
Examination of complications of birth control surgery
Detailed medical history, physical examination, including gynecological examination. Test blood routine and clotting time. Thorough chest and other tests if necessary.
Thoracic fluoroscopy is a commonly used X-ray examination method. It uses the X-ray to have the characteristics of penetrability, fluorescence and photographic effect, so that the human body forms an image on the screen. Due to the difference in density and thickness of the human tissue, when the X-ray penetrates different tissues of the human body, the X-ray is absorbed. The degree of X-rays on the screen is different, forming different images in black and white, which provides a basis for doctors' diagnosis.
Diagnosis
Diagnosis and diagnosis of complications in birth control surgery
diagnosis
According to the history and symptoms of birth control surgery, it can be diagnosed.
(1) Detailed medical history and contraceptive history.
(2) For gynecological examination.
Differential diagnosis
Gas embolism aspiration or hysteroscopic or laparoscopic surgery related to birth control, due to instrument failure or operational errors, gas into the blood vessels caused by gas embolism. When the drug is corrosive and the tubal drug is blocked, the corrosive drugs may accidentally injure other tissues and appear symptoms and signs.
