Excision and hip amputation

In the case of evisceration, the fetal thoracic cavity or abdominal organs are removed to reduce the fetal body and deliver the fetus. Treatment of diseases: thoracic deformity dystocia Indication 1. Ignore the sexual position, the amniotic fluid is exhausted, the contraction is very tight, the position of the fetal head is high, the chest and abdomen are squeezed into the vagina, and the decapitation is difficult. 2. The chest or abdomen has a deformity or the tumor obstructs the childbirth. 3. Siamese deformity tires. Contraindications 1. Aura uterine rupture. 2. The pelvis is obviously narrow or deformed. 3. The mouth of the palace is nearly open or full. Surgical procedure 1. Cut the chest cavity: Strictly disinfect the vulva and the fetal upper limbs, catheterization, vaginal examination to determine the position of the chest and abdomen. Ignore the transverse position, such as the fetal chest into the vagina, when the position is low, you can cut the chest cavity along the assist gap under direct vision (Figure 1). If the position of the chest and abdomen is higher, the assistant will pull the hand that is delivered to the side of the fetal head. The operator holds the long scissors on the right, enters the uterine cavity under the guidance of the left hand, and cuts the skin and muscles of the intercostal space. 2. Remove the internal organs: enlarge the intercostal incision, use the oval clamp to take the heart and lung organs, and if necessary, cut the transverse abdomen to remove the abdominal organs (Figure 2). 3. Pull out the fetus: the chest and abdomen of the fetus is collapsed, and the carcass can be reduced by the following methods. (1) The upper limb of the fetus is involved, and the carcass is folded and delivered. (2) The hand reaches into the uterine cavity to hold the lower limb, and the fetus is delivered according to the hip traction. (3) If the hand that is out of the hand cannot be rotated inside, it is feasible to break the hip. Cut the upper part of the upper arm to cut the skin, muscles, and push the muscles up to the shoulder, then twist the upper limb from the shoulder joint, and if necessary, the scissors will break off. Such a section of the upper arm muscle shield, so that the sharp end of the bone does not expose the soft birth canal. In the case of the prolapsed hand losing traction, the inversion is performed, the fetal foot is pulled out, and the fetus is finally delivered.