Uterine rupture repair

Uterine rupture repair is a surgical method used to treat uterine rupture. It is suitable for the following situations: 1. The rupture mouth is neat and easy to suture. 2, rupture to a shorter operation time, no more than 24 hours. 3, no concurrent infection. 4. The uterine artery was not damaged. 5, no uterine malformations. 6, eager to ask for further births. Treating diseases: uterine rupture Indication 1. The rupture mouth is neat and easy to suture. 2. The rupture until the operation time is short, no more than 24 hours. 3. No concurrent infection. 4. The uterine artery was not damaged. 5. No uterine malformations. 6. Desire to ask for another birth. Preoperative preparation 1. Prepare the skin and place the catheter. 2. Rapid establishment of venous access, preparation of blood, transfusion anti-shock treatment. If necessary, central venous pressure should be placed, combined with urine volume monitoring, to estimate the amount of blood loss. Maternal women with severe shock should be transferred to the hospital in time to avoid delays or loss of rescue opportunities. 3. Uterine rupture, whether partial or complete, requires immediate exploratory laparotomy. Vaginal surgery often causes the rupture to enlarge, aggravating the degree of uterine rupture, causing re-bleeding and then causing shock, or causing damage to other organs in the abdominal cavity, and repairing is difficult. 4. Start using broad-spectrum antibiotics before surgery. Surgical procedure 1. Caesarean section and hemostasis: Take the longitudinal incision of the lower abdomen and cut the abdominal wall into the abdominal cavity. While the blood side of the abdominal cavity is being explored, if the fetus and placenta have entered the abdominal cavity from the uterus, the fetal foot should be quickly grasped, and the fetus and placenta should be taken out. At the same time, the uterus body directly injects oxytocin or the vein advances oxytocin 20U. To reduce uterine contractions and reduce bleeding. Use an oval clamp or an Alice plier to clamp the rupture to stop bleeding. If a part of the fetus is outside the uterus, it should be extended from the rupture with a pair of scissors to the site where the blood vessels are less, and the fetus is delivered. Use the oval to clamp the uterine wound edge and carefully stop bleeding. Check the ureter, bladder, cervix and vagina for damage. 2. The lower part of the uterus is repaired by the transverse rupture: the lower edge of the uterus has been shrunk to a deeper part, and the boundary with the bladder is not easy to distinguish. Carefully find the upper and lower edges of the rupture and lift it with Alice clamp. Lift the bladder peritoneal reflex with a curved vascular clamp. There is no bladder damage. And gently push the bladder away from the lower edge of the uterus to avoid injury to the bladder during suturing. If the scar is split, the scar must be trimmed and then sutured. The stitching must be aligned. The first layer was continuously sutured in the whole layer of the No. 2 gut line, and the second layer was continuously sutured and sutured, and the suture was tightened to ensure a good closure. It is best to embed the incision with a bladder reflexive peritoneum. 3. The lower part of the lower part of the uterus is broken: the repair method is the same as the lower part of the rupture, but it is necessary to pay attention to the uterine blood vessels and ureters when suturing. The damage of the ureter is mostly caused by the anatomical relationship, but it is caused by the clamp of the vascular clamp, the operation is mistaken, or it is miscut. If the above injury occurs, it should be discovered in time, and an ureteral anastomosis should be performed immediately. If the blood vessels are formed by puncturing blood vessels during suturing, the serosa should be cut off in time to remove blood and completely stop bleeding. 4. Wide ligament hematoma: The uterus ruptures on the side of the uterus, injuring the large blood vessels or branches of the uterus, forming a large hematoma in the broad ligament. The anterior and posterior lobe of the broad ligament should be opened first, and the ascending uterus artery and its accompanying vein should be ligated to avoid damage to the ureter and bladder. Attachment resection if necessary. If the bleeding is still severe or the hematoma is expanding and no significant bleeding points can be found, internal iliac artery ligation is feasible. 5. Suspected infection: should be cultured in the uterine cavity, then the uterine cavity, pelvic and abdominal cavity should be washed with metronidazole, and the drainage tube should be placed in the posterior fornix or lower abdomen for drainage. Postoperative diet Suitable diet: 1, should eat fresh fruits and vegetables and other light diet. 2, do not eat spicy spicy food. 3, avoid drinking alcohol.