Pillow horizontal into the basin
Introduction
Introduction The fetus is placed in the basin with the occipital position, and the occipital position should be the normal orientation of the head position. The so-called basin entry is when the pregnancy enters the end, the fetus is surrounded by amniotic fluid and fetal membranes, waiting for the head with the head down, hips up, and body contracted. Before giving birth, the first thing the fetus is forced to do is to get his head into the pelvic cavity through the pelvic inlet of the mother, so that the position of the body is consolidated.
Cause
Cause
The sagittal diameter of the fetal head is larger than the double top diameter. The transverse diameter of the pelvic inlet surface is the largest diameter, which is larger than the slanting diameter and the anteroposterior diameter. This is the reason why the fetal head is easy to adopt the occipital transverse position into the basin.
Examine
an examination
Related inspection
Anal finger examination abdominal plain film
After the fetal head enters the basin with the horizontal diameter of the pillow, most of them can naturally rotate to the front of the pillow. If the fetal head is connected to the front of the pillow with the horizontal position of the pillow, it can be rotated to the front of the pillow or the front of the pillow can be rotated forward to the horizontal position of the pillow. Form a continuous occipital position.
Characteristics of the transverse position of the pillow:
(1) Abdominal examination: 1/2 of the mother's abdomen is occupied by the fetal limbs, and 1/2 is the fetus's back. The upper part of the fetus is touched by the fetal head and wider than the front of the occipital. When the occipital transverse position of the fetal head is not flexed, the average length of the occipital diameter of both sides of the occipital head is 11.3 cm, which may be slightly less than this. The cranial top touched on the shame is not equal, and the side of the fetal head occipital bone is higher than the side of the frontal bone.
Such as the left lateral position of the pillow, the left pubic symphysis of the lower abdomen can be combined with the upper left iliac crest and the occipital part (shaped round hard), the occipital part is 3 fingers high in the pubic symphysis, and the right side of the forehead may only be one finger high, such as The direction of the right lateral direction of the pillow is opposite. The follow-up of the fetal head should be based on the occipital side. When the occipital left lateral position is always in the mother's left lower abdomen, the height of the occipital part should be touched. It is not necessary to switch to the lower right abdomen of the mother to touch it. The touch is only shame on the forehead. Linked to 1 finger, and mistakenly believe that the fetal head has dropped 2 fingers. On the opposite side of the fetal occipital region, the crotch can be touched under the forehead, but because the iliac crest is too lateral, it is not as easy to reach as the posterior occipital position. The fetal heart is most loud on the lateral side of the lower abdomen of the same side of the occiput.
(2) Anal examination and vaginal examination: the sagittal suture of the fetal head is on the transverse diameter of the pelvis. When it is just in production, or when there is a head basin, the fetal head can be laterally flexed to reduce the diameter of the basin. After the fetal head, the uneven head is placed in the basin, so that the top of the head enters the basin first, and the sacral recess is used to retreat. The front top is slipped from the shame and then down to form a uniform slope and then fall. Therefore, the sagittal suture of the fetal head first moves forward to the shame, and then back to the middle of the pelvis, which is the normal birthing machine. If the occipital transverse position adopts the unequal inclination into the basin (the former uneven inclination) for abnormal delivery, it will be discussed in the following chapters. When the pillow is in the horizontal position, the front squat is on the left side of the pelvis and the squat is on the right side. When the left side of the pillow is in the horizontal position, the front squat is on the right side of the pelvis and the squat is on the left side.
Diagnosis
Differential diagnosis
Pillow lateral position into the basin symptoms need to be identified with the following symptoms
1. The uneven position of the occipital position and the head basin are not called: the occipital transverse position can not be diagnosed as the uneven uneven position, and the uneven position after the occipital transverse position is accompanied by the head basin. Identification. After the uneven head tilt combined with the head basin does not mean that the fetal head can not be connected and lowered, the sagittal suture of the fetal head is in front of the transverse diameter of the pelvis. When the left occipital lateral position is unevenly inclined, the fetal head edema is on the left parietal bone, and the posterior occipital edema of the right occipital lateral position is on the right parietal bone. This item can be distinguished from the previous uneven tilt position.
2. Pillow transverse position is tilted: the common point of both is that the sagittal suture of the fetal head is consistent with the transverse diameter of the pelvis. The difference lies in the fact that before the occipital position, the uneven head tilting into the basin is more difficult to tilt than the occipital transverse position. The vaginal examination of the sagittal suture is not in the middle of the pelvic plane and is biased toward the sac, and the unequal tilting position is mostly vaginal delivery. Difficulties in postpartum fetal head and apex can help identify.
3. The anterior position of the occipital and the posterior position of the occipital position: the anterior and posterior iliac crests of the fetal head are moved backwards when the front is unevenly inclined. If the left occipital lateral position is unevenly tilted into the basin, the front squat is at 7 to 8 o'clock. Position, easy to mistakenly think that the front of the left occipital, the posterior iliac crest at 4 to 5 o'clock position, easy to mistake the left occipital posterior position. The key to diagnosis is to find out whether the sagittal suture is parallel to the transverse diameter of the pelvis, and the transverse radial sac is moved to the front uneven inclination. Finally, the location of the fetal head edema was determined. There is more difficulty in vaginal delivery before the uneven tilting, and soft birth canal laceration is easy to occur through vaginal delivery.
