Fetal head suction

The applicationofvacuumextracfor is a midwifery operation in which a special suction device is placed on the fetal head to form a negative pressure and then sucked on the fetal head to assist in the delivery of the fetal head. The patient took the bladder lithotomy position, disinfected the vulva and catheterization, and generally did not need anesthesia for the perineal incision. Most of the primiparas need to be cut off. Fingers gather like a cone, and the disinfectant infiltrant slowly spreads into the vagina, further checking the height of the cervix and the position and orientation of the head. The orientation of the fetal head is determined by examining the position of the front door or the direction of the auricle. Treatment of diseases: persistent occipital transverse dystocia, soft birth canal abnormal dystocia Indication The uterus is weak, the second stage of labor is prolonged; suffering from heart disease, tuberculosis, pregnancy-induced hypertension or previous cesarean section, etc., should not be excessively exerted during birth; placenta previa, placental abruption, umbilical cord prolapse and fetal palace Internal asphyxia, etc.; persistent occipital position, childbirth progress is too slow; cesarean section fetal head delivery difficulties, can be assisted with forceps. Contraindications The fetus is not suitable for childbirth from the vagina, such as severe head basin is not called, the birth canal obstruction, birth canal malformation. Preoperative preparation The patient took the bladder lithotomy position, disinfected the vulva and catheterization, and generally did not need anesthesia for the perineal incision. Most of the primiparas need to be cut off. Fingers gather like a cone, and the disinfectant infiltrant slowly spreads into the vagina, further checking the height of the cervix and the position and orientation of the head. The orientation of the fetal head is determined by examining the position of the front door or the direction of the auricle. If the vagina is tight, you can use your fingers to gently rotate back and forth in the vagina to facilitate the passage of the fetal head. Surgical procedure The operator uses the index finger and middle finger of the left hand to open the posterior wall of the vagina, and the right hand holds the suction device. The large end of the suction device is fed through the posterior wall of the vagina, and the trailing edge reaches the top of the fetal head and is closely attached to the top of the fetal head. Check the attachment position of the attractor. The right hand food and the middle finger touch along the big end edge of the suction device to push open the tissue between the suction device and the fetal head. The negative pressure is sucked so that the negative pressure inside the suction tube is attached to the head. Listen to the fetal heart, if there is no abnormality, you can slowly pull in the contraction. Start to pull down slightly as the head descends, the perineum is somewhat bulging and turn into a flat pull. When the head pillow is exposed under the pubic arch, the perineum is obviously bulging, and gradually pulls up. The suction cylinder should rotate with the rotation of the head. When the flat surface of the head is delivered, the hemostatic forceps can be released, the negative pressure can be removed, the suction tube can be removed, and the child can be delivered by hand. complication Maternal complications (1) Cervical laceration: Because the cervix is not open, it is necessary to determine the opening of the cervix during vaginal examination. (2) Vulvovaginal laceration: Most of the perineal incision is too small or the vaginal wall tissue is poorly elastic. If necessary, a full perineal side cut should be performed. (3) vaginal hematoma: Because the vaginal wall is sucked into the suction device, it must be carefully checked after rotating the suction device to eliminate the soft tissue compression, and the hematoma is not necessary to deal with. 2. Fetal complications (1) scalp hematoma: excessive negative pressure or excessive traction, long traction time, more than one month of natural absorption, no special treatment, to avoid puncture or hemorrhage, to prevent infection. If the scalp hematoma increases rapidly, those with active bleeding should be cut to stop bleeding. (2) intracranial hemorrhage: according to neonatal intracranial hemorrhage. (3) Skull injury: It is related to attracting excessive negative pressure or excessive traction. Most of them are linear fractures of the skull, which can be self-healing without treatment. Rare concave fractures can affect brain tissue and should be treated surgically. Maternal and child complications can be avoided with good and standardized operation, and the damage occurred is slight, and no special treatment is needed.