Transabdominal tissue forceps retraction of the uterus

Uterine pull-out refers to the endometrial facet-out, a rare serious obstetric complication that can cause bleeding, shock, and infection. Acute uterine overturning was not detected and rescued in time, and the maternal mortality rate was very high. It usually occurs in the third stage of labor, and very few are within 24 hours after delivery. Mainly in the case of poor uterine contractions, cervical relaxation, the placenta has not been stripped by violence to pull the umbilical cord or strong pressure on the bottom of the palace. Occasionally, when the umbilical cord is too short, when the fetus is over-extended or the submucosal fibroids protrude to the outside of the cervix, the uterus is turned out. Therefore, the correct treatment of the third stage of labor is the key to preventing the uterus from turning out. The uterus can be divided into acute and chronic. Immediately after the uterus is turned over, it is acute. If the symptoms are not obvious, it is ignored or not treated in time. After a few days, due to the contraction of the cervix, the blood flow of the uterus is blocked, edema and necrosis can occur, causing infection and septicemia. There are also a few diseases that have become chronic due to the gradual resumption of the uterus. According to the degree of uterus turning out, it can be divided into three types: the bottom of the uterus is turned out in the lower part of the uterus or partially protrudes from the cervix, which is called incomplete uterus. The endometrial surface is turned out into the vagina. The uterus is completely turned out; the uterus that has been turned out is prolapsed outside the vaginal opening, and the uterus is prolapsed. The symptoms of incomplete uterus are mild, and there may be mild abdominal pain. The latter two symptoms are obvious. The mother feels severe abdominal pain. Painful shock may occur due to the pulling of the ureter, ovaries, ligaments and peritoneum and the stimulation of nerve endings. . Therefore, after the delivery of the lower abdomen pain with unexplained shock should consider the uterus. Generally diagnosed by abdominal and vaginal examination. It should be actively treated after diagnosis, and it can be reset by different methods while preventing infection and actively preventing shock. The method of reduction has a manual reduction and a surgical reduction, and the surgical reduction has a transvaginal and transabdominal reduction. Acute uterine retraction can be performed by vaginal hand reduction. If the reduction fails, it can be reset by abdominal surgery. Chronic uterus retraction must be treated surgically. If serious infection or tissue necrosis occurs, hysterectomy should be performed after infection control. Curing disease: Indication Transabdominal tissue forceps for uterine reduction is suitable for vaginal hand-reset failure. Contraindications The narrow ring formed by the cervix is tight and cannot expand. Preoperative preparation 1. Give a sedative to relieve pain. 2. Infusion, blood preparation, blood transfusion if necessary, prevention and treatment of hemorrhagic shock. Surgical procedure 1. Dilatation of the cervical narrow ring In the midline of the umbilical incision, after entering the abdominal cavity, the fundus can be seen to form a narrow ring in the vagina, and the ring is first expanded with a finger. 2. Uterine reduction Use two tissue clamps to clamp the inside of the uterine stenosis ring, start pulling up, and gradually shift to the bottom of the uterus until the uterus is completely reset. 3. Promote uterine contractions Immediately after the uterus is reset, uterine contractions are used to promote uterine contractions to prevent them from turning out again. 4. Finally suture the abdominal wall incision layer by layer.