1. Premature rupture of membranes Premature rupture of membranes before uterine contraction is called premature rupture of membranes. After the fetal membranes rupture, the inside of the uterus is in direct contact with the outside world, and intrauterine infection may occur. If there are no uterine contractions and rupture of membranes at term or labor, pregnant women may worry about premature rupture of membranes leading to the loss of amniotic fluid. If uterine contractions do not have the buffering effect of amniotic fluid, will the fetus be in danger? In fact, amniotic fluid is continuously produced. Amniotic fluid is secreted by the fetal membranes, the fetus urinates, and the fetus swallows the amniotic fluid to form amniotic fluid circulation, so expectant mothers do not need to worry too much. Uterine contractions usually begin within 24 hours after membranes rupture. If the baby is full term and the contractions are delayed, the doctor will induce labor. If the baby is not yet full term, the doctor will take measures to prevent intrauterine infection, actively protect the fetus, and try to bring the fetus as close to full term as possible.
Rupture of membranes during childbirth is normal. The fetus can only be delivered if the membranes rupture before delivery. During labor, if the membranes do not rupture for a long time, it will hinder the progress of labor. At this time, the doctor will rupture the membrane in time.
What should you do as a pregnant mother? If premature rupture of membranes occurs, there is no need to panic, but you must be hospitalized and rest in bed; the fetal head is not in the pelvis, and the buttocks should be raised to prevent umbilical cord prolapse; the nature of the amniotic fluid should be closely observed, and pregnant mothers should carefully feel the fetal movement. The occurrence of fetal hypoxia; after membrane rupture, the doctor will give antibiotics to prevent infection as appropriate. It will also be handled accordingly. Pregnant mothers should cooperate with doctors to strive for a smooth delivery.
What would the doctor do?
(1) Premature rupture of membranes is approaching the expected date of delivery and the fetus is mature. If there is no abnormal fetal position, pelvic stenosis, umbilical cord prolapse, low fetal position, etc., it will not affect the labor process and natural delivery can be achieved.
(2) If labor has not yet occurred after 12 hours of premature rupture of membranes, labor can be induced if there is no fetal malposition or cephalopelvic disproportion. If infection cannot be completely ruled out, and there are abnormal fetal positions, intrauterine distress, etc., a cesarean section should be performed immediately, and broad-spectrum effective antibiotics should be given to prevent infection after surgery.
(3) If premature rupture of membranes is far from the expected date of delivery, the fetus is not yet mature, and the pregnant woman urgently needs an abortion, the doctor should perform abortion treatment after ruling out infection. Pregnant women should be closely observed for their body temperature and pulse, whether there is tenderness in the uterus, whether there is any peculiar smell in the amniotic fluid flowing out, changes in fetal heart rate and fetal movements, and treatment with penicillin and other antibiotics that are harmless to the fetus. Keep your vulva clean and avoid unnecessary anal or vaginal examinations. Once an irregular fetal heart rate is found or there is a possibility of infection, the pregnancy should be terminated.
2. Abnormal amniotic fluid Abnormal amniotic fluid includes polyhydramnios and oligohydramnios; or intrauterine hypoxia in the fetus causes the anal sphincter to relax, and meconium is discharged into the amniotic fluid, contaminating the amniotic fluid and turning the amniotic fluid yellow, and in severe cases, it can turn yellow-green. Thick amniotic fluid.
intrauterine infection
The fetal membrane is a barrier between the fetus and the outside world. It isolates the inside of the uterus from the outside world and keeps the inside of the uterus sterile. If there is vaginitis or rupture of fetal membranes, external bacteria will enter the uterus from the vagina, causing infection. The first symptom of intrauterine infection is endometritis, which can lead to polyhydramnios or smelly amniotic fluid. Intrauterine infection is not only harmful to the fetus, postpartum mothers are also highly susceptible to puerperal fever, endometritis, sepsis, etc., and newborns are also susceptible to other diseases such as pneumonia. Therefore, vaginitis should be actively treated during pregnancy and hospitalized after the water breaks.
3. Uterine atony: As labor progresses, uterine contractions gradually intensify, the contraction time becomes longer, and the intermittent time becomes shorter. Strong uterine contractions promote dilation of the cervix and the fetal head droops. However, if the uterine contractions do not increase as the labor progresses, but the contractions are not strong enough and the interval becomes longer, the delivery time will inevitably be delayed. This condition is called uterine atony and is classified as primary uterine contractions. Fatigue or secondary uterine atony.
Causes of primary uterine atony: Pregnant women often do not rest well and are extremely nervous, which can cause uterine atony.
Causes of secondary uterine contractions: If the pelvis is narrow, the birth canal is not smooth, or the fetal head is not in the correct position, labor cannot proceed normally. The mother will feel tired and the uterine contractions will disappear, resulting in uterine atony.
What should pregnant mothers do? No matter what the cause of uterine atony is, the labor process cannot proceed smoothly and the fetus cannot be delivered for a long time. Therefore, as a pregnant woman, you must relax, adjust your breathing carefully during contractions, and sleep with your eyes closed after contractions. When it\’s time to eat, eat some easy-to-digest meals to build up your strength. The doctor will use uterotonics to strengthen uterine contractions according to the situation. The doctor will also determine the cause of uterine atony and actively deal with it. If the uterine contractions are caused by overwork, the doctor will give the pregnant woman a certain amount of medicine to allow her to take a break and eat something to regain her strength, so that strong uterine contractions will come again.
In addition to the above reasons, if the cervix is close to full dilation, the contractions will also weaken. This is the deceleration phase of the labor process. At this time, the expectant mother should wait patiently on the delivery bed for uterine contractions, adjust her mood, and prepare for the moment of delivery.
4. Working long hours
The average delivery time for a first-time mother is 8-16 hours. However, everyone\’s labor progress is different. In medicine, the whole process of childbirth is artificially divided into latent period, active period and labor period. Each stage has a certain time limit. But if the fetus has not been delivered for longer than the average time, it means that the labor process has been prolonged.
The most common reason is uterine atony; the second is that the soft birth canal is hard or the pelvis is narrow, and the fetal head cannot descend. Third, the direction of the fetal head entering the pelvic cavity is abnormal, resulting in abnormal fetal position, or the umbilical cord is entangled and hinders delivery.
How to do it? Prolonged labor will cause the fetus to be squeezed in the birth canal for a long time, causing intrauterine hypoxia, and the mother will be unable to give birth for a long time, resulting in excessive physical exertion, postpartum hemorrhage, postpartum infection, etc. Therefore, when prolonged labor occurs, doctors will actively look for the cause of the prolonged labor and actively deal with it.. If uterine contractions are weak, the above measures can be taken to strengthen uterine contractions. If the mother is extremely tired, she can adjust by resting and providing energy. If delivery cannot be successful even after taking appropriate measures, it may be that the fetal head is not in harmony with the pelvis (cephalopelvic disproportion), and other delivery methods should be chosen.
5. Premature separation of the placenta The placenta is the organ of the mother\’s body that provides nutrients and oxygen to the fetus. Therefore, the placenta is closely connected with the uterine wall to ensure the normal function of the placenta. But when for some reasons, such as pregnancy-induced hypertension, vasospasm, or trauma, the placenta detaches from the uterine wall prematurely, which is medically called placental abruption, it is very dangerous. This situation threatens the lives of mother and child and must be a cause for concern. Although placental separation is not known to pregnant women, the possibility of placental abruption should be considered when pregnant women with pregnancy-induced hypertension or trauma present with persistent abdominal pain and vaginal bleeding.
what to do? Once the above situation occurs, you should go to the hospital immediately. In order to save the life of the fetus, doctors
The students will perform emergency surgeries. Therefore, it is necessary to strengthen prenatal examination during pregnancy, actively prevent and treat pregnancy-induced hypertension syndrome, strengthen management of high-risk pregnancies such as hypertension and chronic nephritis, and avoid supine positioning and abdominal trauma in late pregnancy.
6. Abnormal umbilical cord
Invisible prolapse of the umbilical cord, the cervix is not opened, and the umbilical cord reaches the pelvis before the presenting part of the fetus and is easily compressed.
After umbilical cord prolapse and fetal membrane rupture, the umbilical cord first enters the vagina and is easily pressed by the exposed part of the fetus and the birth canal, causing compression.
The umbilical cord is wrapped around the fetal neck and other parts of the body. The umbilical cord may be pulled or compressed during delivery.
Umbilical cord nodules There are real and false umbilical cord nodules. A true umbilical cord nodule is a knotted state of the umbilical cord. If the nodule is too tight, it will hinder blood circulation and cause the fetus to die in utero. Pseudonodules are coiled blood vessels that do not pose a life-threatening risk to the fetus.
Solutions In the two cases of invisible umbilical cord prolapse and umbilical cord prolapse, because the umbilical cord is compressed and hinders blood circulation, the fetus is in a state of hypoxia. In most cases, doctors will immediately perform a cesarean section. Generally, spontaneous delivery can be achieved with umbilical cord entanglement. Changes in the fetal heart rate can be observed during labor. Once the fetal heart rate changes, the delivery method can be changed immediately.
We would like to remind expectant mothers that we cannot control the condition of the fetus in the womb. The fetus and the mother are two individuals and will not change because of our excessive worry or unexpectedness. As expectant mothers, we just need to observe carefully and nip problems in the bud. Don’t worry too much, which may lead to restless eating and sleeping, which is not conducive to the growth of the fetus. I wish everyone a safe delivery.