Parent-offspring's guide: 15 caesarean birth reason analysis which the hospital tells

Parent-offspring's guide: 15 caesarean birth reason analysis which the hospital tells
According to the latest report, our country cuts open the palace to produce at present (caesarean birth) Rate is close to 50%, occupy " the first in the world " . The report is thought, carry off this one " the first " The hospital has big responsibility, " doctor of a lot of obstetrical department, nurse utilize information asymmetry, induce the lying-in woman to choose the caesarean birth consciously or unconsciously, give up the natural labor. " This is certainly because of the drive of interests, the expenses of caesarean birth are far higher than the natural labor. But the popularization of knowledge with raising healthier, better educated children, a lot of ready-to-be mothers have known the advantage of giving a birth naturally, then treat lying-in women or relatives as one, how to analyze to the reason which the hospital tells? -The reason one: The firstborn is expert's view of caesarean birth: Caesarean birth for the first time, regenerated child want caesarean birth too say, if the reason of the first fetus caesarean birth is because of abnormal fetal position, the amniotic fluid is too dense and thick, the intersection of foetus and the intersection of heartbeat and factor such as being good, second child successful probabilistic of natural birth those can reach 80%- 90%. If choose caesarean birth at one farrow because pelvis too little producing Cheng to be sluggish, those second child natural births will have the miss ratio up to 60%- 70%. Whether the second child takes the caesarean birth to still relate to first caesarean birth operation way. Adopt the intersection of uterus and crosscut operation at one farrow, second child natural birth take place probability that uterus breaks about 0.5% - 4%; Adopt, cut or pour the intersection of T and cutting method directly at one farrow, second child probability that uterus breaks about 9%. In general terms, 60%- 80% can cut open women whose vagina gives a birth of postpartum naturally of belly finally to try natural labors. The American gynaecology and obstetrics learns to think: The indication of caesarean birth of last time has not existed yet; Do not claim, not amalgamate indication of caesarean birth such as disease or complication seriously without head basin while being pregnant this time; Having only done a caesarean birth operation in the past, and the notch of the uterus was to play one section of crosscut mouths at that time, then possess and try the primary condition of natural birth. If the lying-in woman has done the caesarean birth operation one or more times, or the notch of the uterus upside is cut-outing vertically (call " caesarean birth of the Greco-Roman Style " )Or T - shape cut-out, give birth to danger that uterus break can increase greatly while being natural so, it is unsuitable to try the vagina to give birth to. -The reason two: The positive expert's view of surface antigen of lying-in woman's hepatitis B: Different to give birth to way have, influence traditional view think to the intersection of HBV and mother-to-baby transmission hepatitis B the intersection of surface and the intersection of antigen and positive pregnant woman propagate the virus to give to the future generation vertically, give birth to the biggest possibility of mode of production naturally with the birth canal. So think the caesarean birth is to prevent the birth canal of mother and baby from transmitting the best means of hepatitis B and virus. The domestic doctor has specialized in this in recent years, reveal result,persons who carry hepatitis B virus caesarean birth and give birth to naturally hepatitis Bs neonatal is positive to lead difference not to be dominanced in virus. Acute infects one or serious disease hepatitis lying-in woman and is suitable for caesarean birth, the chronic hepatitis or light hepatitis lying-in woman can choose the vagina to give a birth, but should reduce and test-manufacture the incidence failing as much as possible. -The reason three: Foetus " oxygen deficiency " Expert's view: Misdiagnose oxygen deficiency and select foetus' medical science of oxygen deficiency in palaces of caesarean birth to be called the poverty-stricken disease in foetus' palace by mistake, it is gestation later stage and give birth to a common complication, can jeopardize foetus' health and life. Set up and monitor the gradual popularization of the method, the obvious improvement of diagnosis that the recessive fetus is poverty-stricken with enclosing and producing medical science, can also do the intersection of caesarean birth and surgery because the doctor's diagnosis error but the appearance is false and positive, this too cuts open one of the raised reasons of the yield of the palace in recent years. The traditional view thinks, it is foetus' sign which is short of oxygen that the excrement of amniotic fluid dyes. Many scholars think in recent years it might not be foetus' behavior which is short of oxygen that the excrement of simple amniotic fluid dye, especially the foetus in the maturity. It may be that the umbilical cord is pressed and caused fan's absent-minded result strengthened in vigor that the excrement of fetus appears. Otherwise discover, it is lowest that the fetus heart electron nowadays most often used is monitored unusually and the conforming of the suffocating rate happen, it is only 3.33%. The fetus heart guards the appearance to apply to clinic extensively, though has saved and endangered high in recent years, but result in cutting open the rising of the yield of the palace in recent years. The fetus heart guards the high false positive rate. The foetus has hypoxia slightly, can unusually pursue the heart rate of the fetus. However, when it is unusual that heart guards the fetus with excrement dyeing, fetal movement of amniotic fluid, fetal movement fetus heart unusually combines together, the neonate suffocates the percentage of the relevant factor in straitened circumstances of the rate, fetus obviously rises. So diagnose foetus' oxygen deficiency needs comprehensive analysis, can't draw a conclusion carelessly, avoid causing unnecessary intervention to the foetus, do the intersection of caesarean birth and surgery too early blindly. -The reason four: Foetus' umbilicus winds the neck expert's view: Umbilicus whether absolute indication of caesarean birth run into, require lying-in woman do caesarean birth because Ultrasonography B briefs the foetus on a umbilicus around the neck by some doctor often in obstetrical department around neck. Have doctor say frankly umbilicus make caesarean birth around neck, once baby go wrong, it is difficult to explain to relatives. It is generally acknowledged the umbilicus has something to do with the long and fetal movement of umbilical cord frequently around the neck. The funicular blood vessel is spiral in shape, and itself is undertaken by colloid and wound, there is certain elasticity. Around the intersection of neck and with have something to do with around elasticity and funicular size that count, twine Zhou of neck impact on foetus umbilical cord. Find the umbilicus might not need making and cutting open the palace to produce around the posterior military press, so long as does not influence fetus heart and fetus head to drop, can give birth to the vagina. Only it have foetus change unusually obviously ' such as poverty-stricken at foetus palace) When and not if you can't produce by Cheng, last fetus head while dropping, consider not if you can't cut open by palace, producing just. There are umbilical cords that can be exceeded, observed the blood resistance of umbilicus around the pregnant woman of the neck after being in hospital through making the color, observe the fetal movement, listen to the fetus heart hardworkingly, or measure of guarding the electronic fetus heart etc., understands the inside information condition of the palace at any time, take measures in time. A large number of clinical experiences prove, the only effective umbilical cord around the neck person of umbilical cord is greater than 30 centimetres, it is still safe to give a birth naturally. -The reason five: There is too little amniotic fluid Expert's view: Simple amniotic fluid must do caesarean birth while being too little " there is too little amniotic fluid " It is the common reason why the doctor recommends caesarean birth. The person who less thans 300 ml of sheep's water yield in later period for gestation, is called too little amniotic fluid. It at least refers to getting rid of overdue gestation that the simple amniotic fluid is passed, has not amalgamated disease and complication, the fetus heart was guarded and marked the normal ones synthetically after the foetus was born in. Because domestic finding too little to amniotic fluid once, amniotic fluid too little foetus poverty-stricken and neonate suffocate and the intersection of amniotic fluid and incidence that excrement dye obviously increase, therefore a lot of scholars think amniotic fluid too little it is the behavior in early days of foetus' oxygen deficiency, recommend doing and cutting open the palace to produce as soon as possible. The result of study shows in recent years, the foetus of too little pregnant women of simple amniotic fluid has not really stored in the oxygen deficiency in the palace, can strengthen and guard while producing, walk the vagina is test-manufactured. Have 226 the intersection of example and the intersection of amniotic fluid and too little research besides prove simple amniotic fluid whom too little vagina give a birth enclose, give birth to result and sheep water yield getting normal to show the difference too, some has studied and drawn the similar conclusion abroad too. -The reason six: Expert's view of abnormal fetal position: The foetus is the head downward under the state that most abnormal fetal position can be usually corrected, until the location of head was borned, this was to give a birth normally. If the foetus' other positions In the bottom, are called abnormal fetal position. There are two kinds of common abnormal fetal position: Location of buttocks and horizontal location. The position of a foetus is incorrect and real will cause and have difficult labour. 7 months in gestation ago, abnormal fetal position has possible foetuses to become a full member automatically, in if month of 8 of gestation, do not become a full member yet, need to take measures to correct the position of a foetus in position of a foetus. Correcting the pregnant woman of the position of a foetus can go on under the guidance of doctor. The commonsense method has location of chest knee that corrects the law, lies supine in the location and corrects the law, side and bows the location and corrects the law. The gynaecologist must find, correct the pregnant woman's abnormal fetal position in time when it is examined that pregnant, must not regard abnormal fetal position as a kind of reason of caesarean birth, did not tell to the pregnant woman until just before giving birth, this is lacking a kind of behavior of professional ethics. -The reason seven: The foetus is too big Expert's view: Can't be provided only according to Ultrasonography B " Foetus' weight is too big " Determine that cutting open the belly utilizes supersonic wave to estimate foetus' weight in advance before labor, the error is �� 15%, the weight of foetuses measured before 24 weeks that pregnant, the error is larger. It is very accurate too that the experienced clinician depends on stroking sometimes. Because Ultrasonography B examines foetus' weight to pass, measure the size of child's arm leg, these indexes of the diameter of the head, then cooperate with formulae to calculate. The error sometimes of this result of calculation can be very great. So, " foetus' weight is too big " that can't be provided only according to Ultrasonography B Determine caesarean birth, want, synthesize other relevant the intersection of terms and substantially as assessing big or small and natural production of lying-in woman's pelvis possibility of lying-in woman in experienced obstetrician, that is to say foetus overweight may not necessarily grow, come out, want, pay special attention to the shoulder have difficult labour, but the shoulder is blocked) . The clinical general definition foetus can be regarded as more moderate weight within 2500 gram to 4000 gram, smaller than 2500 grams smaller, can be diagnosed as enormously while greater than 4000 gramsing, generally regard being enormous as the indication of caesarean birth. If estimate children, more than 4 kilograms, natural labor is more difficult, but this is not absolute, if the pelvis condition has a natural labor condition big enough. -The reason eight: Narrow expert's view of the pelvis: The pelvis is narrow and various in style, do not want the caesarean birth The obvious head basin does not claim (absolute pelvis is narrow) Namely sacral bone shame external diameter lt; 16cm, lt in front and at the back of the entry to the pelvis directly; 8.5cm person, lives maturely the fetus can't enter the basin, can't give birth to the vagina s. Should be close to expected date of childbirth or facing the postpartum to walk the caesarean birth finishes giving a birth; The slight head basin does not claim (relativity pelvis is narrow) Namely sacral bone shame external diameter 16cm- 18cm, 8.5cm- 9.5cm directly in front and at the back of the entry to the pelvis, the weight lt of the mature living fetus; 3000 grams, heart rate of fetus is normal, should test-manufacture under guarding tightly. It test-manufacture if it appears that palace is weak without being contracted at course,fetal membrane persons who do not break can pedestrian worker membranes broken when the mouth has expanded 3cm in the palace. If broken the intersection of membrane and seraglio contract relatively strong, produce Cheng, make good progress, majority can give a birth naturally by vagina. If test-manufacture for 2- 4 hours, the fetus head still delays entering the basin, or with foetus' poverty-stricken sign, should do and cut open the palace and produce the skill in time and finish giving a birth. If the fetal membrane has been already broken, infect in order to reduce, should shorten and test-manufacture time appropriately. -The reason nine: The placenta wears out (placenta calcification) Expert's view: The placenta under Ultrasonography B wears out inaccurately " the placenta wears out " It is a formulation not very scientific. Because the placenta is like child, there are a taking place, grow up, development, ripe course, arrive grades of a lot of people think, wear out, tertiary to can only be regarded as ripely after pregnant 35 week in fact, can not say it wears out. The quality of the placenta function needs assessing synthetically according to the checking of a lot. If only according to what Ultrasonography B is left " The placenta wears out " Will carry on the caesarean birth soon, this is not scientific. Because Ultrasonography B it watches calcification to be absolutely accurate, easy to influenced by a lot of factors, false and positive. The doctor judges the placenta maturity through Ultrasonography B, mainly pass the calcification on the placenta to click. Different doctors, judge the error is very great. Then, how could make a definite diagnosis of the placenta and really wear out? Do Ultrasonography B check, see the intersection of placenta and some calcification (select experienced doctor watch, it depends on conscientiously carefully) Beyond, it depends on how much the amniotic fluid is, it is normal that the color goes beyond and sees speed of blood flow of the umbilicus artery, fetus heart monitor, see fetal movement normal, urine check female three alcohol and skin anhydride ratio, check that losses cells,etc. on the vaginal wall, must make a definite diagnosis of after considering synthetically. Placenta wear out, amalgamate the intersection of fetus and heart, monitor, brief foetus on, have which is short of oxygen situation or amalgamate amniotic fluid to be too little at the same time, could prove baby's situation in palace is not good, it is poverty-stricken in the palace to point out foetuses, should carry on the caesarean birth as soon as possible. -The reason ten: The view of older expert of the lying-in woman: Older itself is not the indication advanced age of caesarean birth the lying-in woman means age is over 35 person. The lying-in woman belongs to and endangers one of the gestation high, because increase with age at advanced age, the collagen of the organism has been reduced, influence the toughness of the cervix uteri in the reproductive system collagen, so the modern doctor is often Israel " The lying-in woman of advanced age " As a indication of operation. But it is all at the venerable age of lying-in woman that need caesarean birth, lying-in woman give a birth even very much smooth naturally many advanced age in fact. This piece see personal situation, if child big, lying-in woman age reach 35 year old just, have, pregnant high complication of soliciting etc., give a birth and happen in the seraglio and contract well, foetus' position is normal, other all respects have no indication of caesarean birth, can carry on the vagina and give a birth and test-manufacture. However, should monitor the situations of lying-in woman and foetus frequently, expected date of childbirth has already passed and found foetus poverty-stricken, should consider the operation at once. -The reason 11: Expert's view of foetus' buttocks: Should not make buttocks one of caesarean birth to mean the foetus' foot or buttock while giving a birth gives birth to the vagina first in the location of buttocks, it is most common one in the unusual position of a foetus. The buttocks can be divided into three kinds location. First, the one of straight buttocks of single buttocks location or leg, namely one pair of hip joints of the foetus' flexes, one pair of knee joints is stretched, only the buttocks, in order to reveal the part first. This kind of situation takes place many; Second, complete the location of buttocks or mix the buttocks one, namely the foetus' hip joint and one pair of knee joints flex, revealing department has both buttocks and feet first. This kind of situation is many too; Third, the foot location, namely the revealing department, as a foot or one pair of feet first. Fetus, in the body, it is old than buttocks for head to enclose, head reveal give a birth, first, can have sufficient time enable the intersection of child and hair mould the shape, gives birth to inside so as to adapt to pelvis. Give birth to as the intersection of fetus and head, fetus the intersection of body and other parts thereupon give birth to rapidly too. When single the intersection of buttocks and location and complete the intersection of buttocks and location, if already dropping to the vaginal mouth and exposing revealing department first, uterus mouth many to turn on the whole fully, at this moment, such as make the intersection of foetus and buttock and head until will certainly person who give a birth rotate from until mother present the state floating in the uterus, to give birth to the birth canal smoothly, need passing the numerous health and adjustment of head position, such relevant adjustment of position, in produce learn, calling the giving a birth machine rotating, can be divided into floating, fixed and left in order It lower, flex at head, turn round inside, not spread, turn outside round, give birth to crop, after there give birth to and give birth to is shoulder) ,Can reduce enclosing newborn baby's mortality of buttocks one. But when the foot reveals first, even when the vaginal mouth see fetus foot, the uterus mouth may not necessarily fully open completely either, must stop up the buttocks at this moment, does not make the fetus foot take off out of the vaginal mouth, until fetus foot and buttocks have already been dropped to the vaginal mouth and get along with, uterus mouth turn on large totally, can all give birth to the foetus according to complete the intersection of buttocks and method that location give a birth. So, it is right to give a birth and comparatively unfavorable in the location of foot. However, so long as it is apt to deal with, will give a birth smoothly. Then, in what case, need to do the caesarean birth in the location of buttocks? If lying-in woman's pelvis is narrow; The foetus leans towards big and appearing behind the fetus head and having difficulty in; The lying-in woman has internal and external departments to amalgamate disease; There is history of having difficult labour; Lying-in woman of the beginning at advanced age over 35; The strength of contracting of the palace is weak; The lying-in women are nervous,etc. all need to do the caesarean birth. That is to say that needs the doctor to consider in the situations of various fields of antenatal foundation birth canal, mother's body, foetus synthetically, and then determine whether to need caesarean birth. In the course of giving birth to, the foetus' state is very important too. If fetus heart bad, foetus poverty-stricken in palace, must do caesarean birth as soon as possible. -The reason 12: Pregnant hypertension expert's view: Pregnant the intersection of hypertension and vagina give a birth more safely hypertension meet to 10% of the pregnant women perhaps. Sometimes hypertension is the only abnormal state, sometimes is accompanied by the edema and proteinuria at the same time, called the eclampsia earlier stage or poisonous blood disease of gestation. Eclampsia is very troubling in earlier stage, because this can cause the damage of liver, kidney and other organs, even cause and faint from fear (eclampsia) . Eclampsia is previous only " Cure " The method is to give a birth, and in order to protect mother's health, even premature delivery needs to give a birth. Propose carrying on such a childbirth - -By sacrificing foetuses as the cost in order to protect mother - -It is one of obstetrician's most difficult decisions. Blood pressure 180mmHg/110mmHg, especially while amalgamating other symptoms, it may be the indication needing to give a birth. As to even more like this namely mature pregnant woman of gestation, because the risk to the foetus can ignore at this moment. As hypertension takes place in early days in gestation, the nursing staff can use medicine, staying in bed, or other methods to make and give a birth to postpone, thus enable foetus to continue development. Even if hypertension or eclampsia is the indication of giving a birth, but might not be the indication of caesarean birth either. In case of hypertension, vagina it gives a birth to be safe too usually, even good. The vagina can prevent the operation from giving a birth while giving a birth (caesarean birth) Risk. Under these situations, usually use the medicine induced labor, for example make the palace neck soft with the oxytocin or prostaglandin, the palace is drawn back at the beginning. As the induced labor, need the risk of caesarean birth to be higher than the spontaneous childbirth; Even after taking various measures, palace neck may enough relaxation reach, allow foetus to pass still. However, the induced labor can realize that there is no vagina of complication to give a birth under more situations. When childbirth, no matter vagina give a birth and the caesarean birth can use medicines to lower blood pressure. In addition, often reduce the risk fainting from fear with magnesium sulfic acid. -The reason 13: Amalgamate the anaemia expert's view in gestational period: Gestation should choose gestational period for the natural labor to amalgamate anaemia generally belonging to iron deficiency anemia while amalgamating iron deficiency anemia, the case of obstacle anaemia of chronic regeneration is relatively rare, the morbidity is about 0.029% to 0.08% giving birth to the total number. Even amalgamate regenerated obstacle anaemia, need to carry on the caesarean birth, the medical circle still exists and disputes in recent years, there is not a final conclusion yet at present. It is more common to amalgamate iron deficiency anemia in gestational period, because the pregnant woman obviously increases to the requirement of the iron, the requirement including foetus of the iron takes 350 milligrams of irons to grow in the whole pregnancy period, parent's blood capacity takes 650 milligrams of irons to increase, deducts the pregnant woman and piles up 200 milligrams of irons in the body, so need 800 milligrams of irons in pregnancy period, need irons and is 4 at more least milligrams every day, and the normal diet can only offer 1 milligram - 1.5 milligrams every day, so apt to cause pregnancy period anaemia. But gestation amalgamates anaemia and does not need to cut open the palace to produce, the opposite caesarean birth increases the postpartum and bleeds, make anaemia become more serious, so should choose the natural labor as much as possible, but should pay attention to preventing the uterus from shrinking weakly and preventing from bleeding, preventing from infecting postpartum postpartum in the course of giving birth to, it corrects to anaemia and accords with the level of the operation requirement to amalgamate another lying-in woman with the indication of caesarean birth of anaemia to gestational period, including antenatal transfusing blood by blood transfusion or composition postpartum in production. Simple pregnant amalgamation iron deficiency anemia is not the indication of choosing caesarean birth absolutely. -The reason 14: Prevent thromboembolism of amniotic fluid Expert's view: Give a birth naturally and thromboembolism of amniotic fluid may all take place in the caesarean birth So-called " thromboembolism of amniotic fluid " A large number of amniotic fluid is entered in the pregnant woman's blood, cause the thromboembolism phenomenon, and consume the blood coagulation factor in a large amount, cause the function obstacle of blood coagulation, bring about shock and massive haemorrhage in lying-in woman, even die. Because this kind of situation can't almost prevent or foresee, make the mortality of the lying-in woman up to 90% in advance. Think, give a birth naturally and thromboembolism of amniotic fluid may all take place in the caesarean birth at present. Relatively generally acknowledge three kinds of situations of causing thromboembolism of amniotic fluid are: First, blood vessel of the cervix uteri often split in the childbirth wounded, too strong in the uterus while shrinking to make the fetal membrane got broken, the blood vessel that the amniotic fluid will be injured through splitting enters blood circulation, cause blood thromboembolism; Behind second, pregnant mother's broken membrane, the amniotic fluid can be entered between fetal membrane and uterus wall, reach the edge of the fetal membrane, as the uterus shrinks high strung, the amniotic fluid will pass the blood sinus (very tiny blood vessel network) on the edge of placenta ,It causes thromboembolism to enter blood circulation of the pregnant mother; Third, happen break, the intersection of placenta and strip, leading placenta and make, cut open palace, produce under the situation in early days in uterus, the amniotic fluid is entered blood circulation by the open blood sinus carelessly. Evidence does not prove, the incidence of giving birth to thromboembolism of amniotic fluid naturally is higher than the caesarean birth. On the contrary, some scholars think, cut open women that the palace had, a little greater that the thromboembolism of amniotic fluid and probability of thrombus thromboembolism take place. Because the latter is the operation production, lochia is not easy to excrete out either after production. -The reason 15: Amalgamate the uterus skin tumour expert's view in gestational period: Amalgamate the intersection of uterus and the intersection of skin and the intersection of tumour and caesarean birth lose more than gain pregnancy period 10 the intersection of circle and Ultrasonography B brief on, belong to the lighter skin tumour by 1.1* 1.0 skin tumour generally speaking, needn't worry. Women estrogen secrete vigorous pregnancy period, probably until pregnant week increase the intersection of skin and tumour, can increase a bit too, but later as skin tumour was very normal that increase Ultrasonography B of the uterus can not be seen, not without the excessive concern. As to giving birth to the choice of the way, it is not the indication of caesarean birth to amalgamate uterus skin tumour, but when skin tumour grows and influences the position of birth canal, in this case can choose the caesarean birth. Some doctors and ready-to-be mothers think that there are skin tumour and all right handful of skin tumours in the caesarean birth Cut, kill two birds with one stone. In fact the expert does not propose doing it in this way at present, do it in this way and lose more than gain. Skin tumour increases with increase of the uterus, will shrink with the shrinking of the uterus too in the postpartum too in pregnancy period. Sometimes very small skin tumour is pregnant to grow very big in latter stage in early pregnancy period, but only skin tumour is not out of shape, the ones that do not influence birth canal and foetus give birth to, it is unnecessary to do the caesarean birth in order to remove skin tumour. If caesarean birth reject the intersection of skin and tumour at the same time, it bleeds to be can until pregnancy period special operation go tumour appear much, the blood content inside the uterus is numerous at the time of pregnancy, some blood of uterus skin tumour is very abundant, will appear much blood while rejecting, so lose more than gain. Uterus skin tumour divides into skin tumour under skin tumour and mucous membrane among skin tumour, skin wall under the serous coat. Excise first two kinds of skin tumours, have a little effect on uterus. But caesarean birth want, cut uterus, to to damage, greatly, cut open belly cut skin when the production tumour apt to produce massive haemorrhage while being whole uterus. -Gentle / often happy and brave

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