internal inversion

1. Cross-production live birth, unconditional transfer and implementation of cesarean section. 2. The twin fetus has a high fetal head or a horizontal position, or a fetal distress that needs to be delivered quickly. 3. Some head abnormalities without cesarean section conditions, such as posterior position, frontal position, high straight position, etc. 4. In some cases, the transverse fetus is dead, and it is difficult to perform decapitation. 5. Occasionally used to treat umbilical cord prolapse with failure to return without cesarean section. Treatment of diseases: breech dystocia, dystocia, persistent occipital dysplasia Indication 1. Cross-production live birth, unconditional transfer and implementation of cesarean section. 2. The twin fetus has a high fetal head or a horizontal position, or a fetal distress that needs to be delivered quickly. 3. Some head abnormalities without cesarean section conditions, such as posterior position, frontal position, high straight position, etc. 4. In some cases, the transverse fetus is dead, and it is difficult to perform decapitation. 5. Occasionally used to treat umbilical cord prolapse with failure to return without cesarean section. Contraindications 1. It is estimated that the head basin is not called a live birth that cannot be delivered through the vagina. 2. Uterine scars, prone to uterine rupture or uterine rupture of the aura. 3. Ignore the sexual position, at this time the membrane has been broken, the amniotic fluid is exhausted, and there is no internal reversal condition. Preoperative preparation 1. General anesthesia plus muscle relaxant to completely relax the uterine wall for easy operation. 2. The mother takes the bladder lithotomy position, disinfects the vulva, spreads the towel, and catheterizes. If the membrane is not broken, the membrane is broken. 3. Make a vaginal examination to find out if the cervix is in a meeting, the first exposed and the fetal position. Surgical procedure 1. Reach out into the uterine cavity to find and hold the foot. The back of the fetus extends into the left hand on the left side of the mother, and vice versa. It can also reach into the hand that is easy to operate, usually the right hand. In the horizontal position, if the fetal back is in front of the mother, the lower fetal foot is pulled, the fetal back is behind the mother, and the upper fetal foot is pulled. When the fetal back is up or the head position, the fetal foot is pulled by the mother's abdominal wall, and the fetal back is pulled downward. By the back of the fetal foot, to ensure that the back of the tire is always in front of the mother body when the line is reversed, reducing the resistance during traction and successfully completing the reverse surgery. If it is the head position, when the surgeon searches for the fetal foot in the hand in the uterine cavity, the other hand is placed on the buttocks of the fetus outside the abdominal wall, and the lower hip is pressed to make the hand in the uterine cavity more easily hold the fetal foot. Once you have found one of the required fetal feet, hold it and prepare to pull. The identification of the fetal foot and the hand is that the fetal foot has a prominent heel and the hand does not. The other toes are short and uniform, the toe is slightly longer or flatter than the other four toes, and the thumb is shorter than the other four fingers. 2. Reverse the fetus: Use the index finger and the middle finger to grip the fetal foot and slowly pull down. At the same time, the other hand assists the fetal head to push up the fetal head. The internal and external cooperation will slowly turn the fetus into the breech position. When the fetal knee is exposed to the vaginal opening of the mother, the internal reversal is completed. At this time, the cervix has been opened, and immediately breech traction is used to end the childbirth. If the cervix is not open, the fetus is not distressed, you can pay close attention to the fetal heart, waiting for the cervix to open, for breech delivery or breech traction.