abnormal productivity
Introduction
Introduction Normal contractions have a certain rhythm, polarity and consistency, and have corresponding intensity and frequency. When an abnormality occurs, it is called abnormal productivity, and it is divided into three types: uterine atony, uncoordinated and hyperactive. The most common is uterine atony. The uterine contraction weakness can be weak at the beginning of childbirth. It can also be normal at the beginning, and then gradually weakens. The former is called "primary uterine weakness" and the latter is "secondary uterine weakness." The causes and clinical manifestations of the two are similar, but the latter is often secondary to mechanical obstruction.
Cause
Cause
(1) Mental factors
It often occurs when the maternal spirit is too nervous or fearful of childbirth, causing dysfunction of the cerebral cortex and affecting the normal regulation of uterine contractions.
(two) uterine factors
Excessive extension of the uterine wall, such as twins, excessive amniotic fluid, giant children, uterine dysplasia or deformity, can affect contractions.
(3) The first exposure of the tire can not be close to the cervix
It is not easy to reflect the contraction, which is common in the head basin, breech and transverse position.
(4) Drug influence
Applying a large amount of sedative after labor, inhibiting contractions.
(5) Endocrine disorders
Insufficient estrogen or oxytocin or excessive progesterone in late pregnancy, decreased acetylcholine or decreased sensitivity of the uterus to acetylcholine can affect uterine contractions.
(6) Others
After labor, maternal fatigue, eating less, or the early use of abdominal pressure in the first stage of labor, or bladder filling affects the first drop of fetal exposure, etc., can cause uterine atony.
Examine
an examination
Related inspection
Obstetric examination uterine contraction stress test obstetric B-ultrasound
Weak uterine contractions often extend the labor process, such as more than 24 hours, called "stagnation." The uterus contraction is weak, the tension is reduced, the contraction duration is short and the interval is long. Even when the contraction is not too hard, the mother has no discomfort, but the labor is too long and mental anxiety and fatigue can occur. If the membrane is not broken, there is no adverse effect on the fetus.
Diagnosis
Differential diagnosis
Differential diagnosis of abnormal productivity:
First, the uterine weakness
Uterine contraction is an abnormal productivity. According to the time of occurrence, it can be divided into primary uterine atony (appearing at the beginning of labor) and secondary uterine atony (the cervix opens 3cm into the active period).
Second, the uterus contraction is too strong
Depending on whether the head basin is symmetrical, two different consequences can occur.
1, the contractions are strong and frequent, such as no head basin is not called, the palace mouth often opens quickly, the first exposed part quickly declines, the whole process of fetal delivery can be completed within 3 hours, called "emergency", more common in the maternal . Because of the rapid delivery, often unprepared, prone to serious birth canal damage, placental or fetal membrane residual, postpartum hemorrhage and infection. Due to the frequency of uterine contractions, the blood circulation of the placenta is affected, and fetal distress, stillbirth or neonatal asphyxia are prone to occur. In addition, the fetal head can also cause intracranial damage through the birth canal. If the attention is not enough, the fetus may fall into the ground and produce umbilical cord rupture and bleeding.
For those who have a strong contraction and a history of urgency, they should strengthen observation and prepare for delivery in advance, and prepare for the prevention of postpartum hemorrhage and first aid for neonatal asphyxia. If the contraction is too strong, oxygen can be inhaled or intramuscularly injected with 0.5 mg of atropine to prevent the life of the fetus from being affected by the blood circulation of the placenta. If the disinfection is not strict, both mother and child should give antibiotics to prevent infection. If necessary, give infants a safe injection of tetanus antitoxin. Check the birth canal carefully after delivery, and closely observe whether the newborn has intracranial hemorrhage or infection.
2, if the head basin is not called or blocked for other reasons, the uterus may appear tonic contraction, the upper segment has excessive contraction and contraction, become hypertrophy, the lower segment is extremely thin and tender. There is a great difference in the thickness of the upper and lower muscle walls of the factor palace. A circular shallow groove can be found at the junction, which is called pathological reduction ring, which is a precursor to uterine rupture, often accompanied by hematuria. If not treated in time, uterine rupture will occur. . Fetal survivors can be cesarean section, if they have died, they can be destroyed at their discretion.
