During pregnancy, Jingjing has been in the Obstetric Pregnancy Diabetes Center of Xi People's Hospital (the Fourth Hospital of Xi), and the prenatal examination is in good condition. All the way, I finally reached full term. On February 30th, 65438, I had a routine check-up at 37+5 weeks of pregnancy. Normal fetal position, normal fetal heart rate and normal biochemical examination. Jingjing and her husband are eagerly waiting for the delivery to begin. Bauer was born safely!
However, life is always full of drama. When I came home that night, Jingjing had irregular abdominal pain, which lasted for 8 hours. The young couple were very experienced in waiting until February 3 1, 65438, 08:53, and Jingjing felt that the palace gate was about to open. She didn't come to the hospital until she was 37+6 weeks pregnant to prepare for delivery.
Naughty baby, "head position" becomes "horizontal position" one day.
After admission, Guo Haiyan, the deputy chief physician of obstetrics, examined Jingjing and found that the naughty baby in her belly had changed from "head position" yesterday to "horizontal position". "Transverse position" is an abnormal fetal position, which cannot be delivered through vagina and needs cesarean section. In addition, Jingjing has regular contractions. In this case, once the uterine opening is too wide or the fetal membrane is broken, there will be the danger of umbilical cord prolapse, fetal hypoxia and even death. An adult may also have a life-threatening uterine rupture, and her condition requires an immediate emergency cesarean section. Jingjing and his wife panicked when they heard it, and Jingjing's mother began to cry.
Jingjing gave birth to her first child in the Fourth Hospital, and the second child strongly hoped for a natural delivery. In the outpatient examination, she has been strictly following the doctor's requirements to control her diet and actively exercise. They never thought about caesarean section. After learning this situation, Dr. Guo Haiyan combined with the patient's second child's abdominal wall relaxation and abundant amniotic fluid. During vaginal examination, the uterine orifice is 2cm, and the shoulders and hands of the fetus can be touched. However, after uterine contraction, the fetus is exposed first and then exits the true pelvis, only touching the swollen amniotic sac. Can you change the fetal position through "eversion" to help the baby "turn positive" and avoid cesarean section?
Your trust is my reason for taking risks.
You trust your life, and I will go all out! Dr. Guo Haiyan immediately reported to Bao Lei, the director and chief physician of the Center. On the basis of comprehensive evaluation and preparation for emergency cesarean section, he decided to try "eversion" for it with years of clinical experience.
Before operation, Chief Physician Bao Lei fully informed Jingjing and her family about the potential risks of eversion: syncope in pregnant women, premature rupture of membranes, umbilical cord prolapse, placental abruption, fetal distress, etc. However, the success rate of eversion is about 58%. Combined with the actual situation of Jingjing, under the close monitoring of ultrasound, the success rate of eversion is very large. In case of the above abnormalities, we have made preparations for emergency cesarean section, and the fetus can be taken out within five minutes. Jingjing and her family have been doing checkups in the gestational diabetes center, and they have deep trust and dependence on Director Bao. In addition, she has the desire to have a natural birth. After a brief discussion, the whole family decided to work together with Director Bao to make Jingjing have a dream of a natural birth.
After 2 minutes of bare-handed tire transfer, the baby smoothly "turned positive"
On the premise of preparing for emergency cesarean section, on the morning of 65438+February 3 1 Sunday 10:00, Director Bao began to perform "lateral supine valgus": under the supervision of B-ultrasound, the baby was lying in the mother's uterus with normal fetal heart and no abnormalities such as umbilical cord around the neck. After a contraction, Director Bao skillfully and orderly pushed his hands on Jingjing's stomach. Everyone held their breath and Jingjing closed her eyes nervously. It took only 2 minutes to see the baby's position change a little, and the violent director helped the baby to "turn positive" with his bare hands! During and after the operation, Jingjing's vital signs such as respiration, heart rate and blood pressure were continuously monitored, and the fetal heart rate was continuously monitored, so that the mother and the child were safe.
This fashion should not be belittled. Because the fetal head floats high, it is likely to turn into abnormal fetal position again. Dr Guo Haiyan immediately bandaged the abdomen and fixed the position of the fetus. Director Bao is going to carry out the next thrilling link: help pregnant mothers to manually break the membrane, let the fetal head fall into the pelvis, and then realize vaginal delivery.
10:45, Director Bao successfully performed high-level artificial membrane rupture for Jingjing, and the amniotic fluid slowly flowed out, and everything went smoothly. At this time, it is not completely successful. Director Bao told us to continuously monitor the progress of fetal heart rate and labor process, ensure that the fetal head enters the basin, and be alert to umbilical cord prolapse and placental abruption. Gradually, Jingjing's pain became stronger and stronger. Dr. Guo Haiyan checked the uterine orifice 2 cm again, and the fetal head was fixed in the basin. The external inversion operation has achieved a staged victory! 1 1:00, Zheng Ling, deputy director of the Anesthesia and Perioperative Medical Center, gave Jingjing an analgesic delivery to relieve the pain caused by contractions. 12:30, the uterus was fully opened, and Jingjing successfully gave birth to a healthy baby of 2890g, without side cutting, and the mother and child were safe! External reversal victory!
This peace and victory is the fruit of the medical team in the whole hospital, especially in the gestational diabetes center, the full embodiment of Bao Lei's serious and responsible superb medical skills, and the perfect display of cooperation and mutual trust between doctors and patients! After giving birth, Jingjing held the hand of Director Bao Lei tightly and shed tears of excitement. What excites her is not only the realization of her dream, but also gratitude, emotion and gratitude! There are four hospitals in obstetrics, and Director Bao Lei can rely on them. More importantly, she has full trust in doctors, so that she can get through this 8 1 crisis and finally get the True Sutra!
popular science knowledge
1
What is external inversion?
Eversion, or fetal rotation, refers to turning the fetus by hand to make it change from a fetal position that is not conducive to childbirth to a head position that is conducive to childbirth. When the fetus is in breech position or transverse position, the operator corrects the fetal position to head position through the operation in the abdomen of the pregnant woman. According to comprehensive literature, the success rate of hallux valgus is 16% 100%, and the overall average success rate is 58%, of which primiparas account for about 40% and multiparas for about 60%. According to statistics, not all pregnant mothers who successfully perform eversion can achieve vaginal delivery as scheduled. About 10% 28% pregnant mothers failed in vaginal trial delivery after successful breech eversion, and terminated their pregnancy by cesarean section. Service.
What kind of pregnant mother can try "eversion"
Indications: singleton pregnancy, confirmed breech or transverse position by ultrasound, no absolute indication of cesarean section, willing to try vaginal delivery.
Relative contraindications: severe uterine malformation, multiple pregnancy, premature rupture of membranes, prenatal bleeding, abnormal fetal monitoring or absolute indication of cesarean section. However, it should also be used with caution for infants younger than gestational age, preeclampsia, oligohydramnios, severe fetal malformation, scarred uterus with abnormal Doppler blood flow.
2
Expert introduction
British male voice group
Title: Chief physician
Resume: engaged in clinical work so far, with a solid theoretical foundation and rich clinical experience. I can skillfully handle all kinds of pregnancy complications, complications and difficult and critical cases, and can successfully handle all kinds of urgent and critical obstetric diseases in time, such as abnormal fetal position, prenatal and postpartum hemorrhage, fetal distress and so on. , especially the recognition of abnormal delivery. Judgment and handling are unique. Be able to learn as many new concepts, new ideas and new technologies of obstetrics and gynecology at home and abroad as possible after work and combine them with clinical work; Paying attention to the prevention of diseases can better solve patients' difficult problems. Strengthen the scientific management of pregnancy, and combine new concepts such as free posture, analgesic delivery and unprotected delivery with clinical practice to better promote natural delivery.
Professional expertise: perinatal health care and prenatal and postnatal care, prevention, identification and treatment of abnormal delivery, gynecological endocrinology and women's health care, gynecological surgery.
Clinic hours: Tuesday all day, Wednesday morning and Saturday morning (Dachaocheng Campus).