decapitation

Decapitation is a procedure in which the stillbirth is cut off from the fetal neck and divided into two parts, the fetal head and the trunk. Cutting the neck with a broken hook is difficult to operate and has more damage to the soft birth canal of the mother. It has been used sparingly. The wire saw (Fig. 1) is simple and safe to operate, and has the potential to replace the broken hook. Treatment of diseases: endometritis, chronic endometritis, acute endometritis, contraindications 1. The transverse fetus survives. 2. There are signs of uterine rupture in the aura. Surgical procedure 1. Prepare to disinfect the vulva and out of the hand before surgery, toweling, catheterization. 2. Vaginal examination to check the expansion of the cervix, the degree of fetal chest embedded in the vagina, the position of the fetal head and the neck, to understand whether there is uterine rupture. 3. There are three ways to break the head. (1) Pull the prosthetic baby's hand to the opposite side of the fetal head to lower the fetal neck and facilitate operation. One end of the wire saw is tied with gauze, one end of the gauze is clamped with the middle finger, and it is fed along the back of the fetal neck, exposed in front of the neck, the yarn is pulled out, the wire saw is passed around the neck, and the wire saw is repeatedly checked. Both ends of the saw are connected to the handle. The single-leaf hook pulls the front and back walls of the vagina, and the wire saw handle is pulled back and forth to make the neck break. Be careful not to break the skin under the neck to facilitate pulling out the tire head. (2) Long-cutting and breaking-head method: the assistant pulls out the upper limb with the same line saw method, the operator enters the uterine cavity with his left hand, hooks the fetal neck, and cuts the skin, muscle and cervical vertebra of the fetal neck under the protection of the finger, the fetal head Disconnected from the carcass, pay attention to retain part of the skin to protect the fetal head. (3) Hook-off method: the assistant pulls out the upper limb with the same line saw method, the operator holds the broken hook in the right hand, and puts it into the uterine cavity under the guidance and cover of the left hand, and sends it from the front of the fetal neck to the upper edge of the fetal neck. The thumb is escorted in front of the broken hook, and the rest of the fingers are hooked on the back of the neck, and the broken hook is hooked back to the neck of the neck, and the neck is used as a fulcrum to pull down, and the stalk is repeatedly rotated left and right to disjoint the cervical vertebra. When the assistant pulls out the upper limb, the surgeon cuts the soft tissue of the neck and cuts the fetal head and the neck with long scissors under the protection of the left hand. 4. Pulling out the carcass of the carcass to prolapse and prolapse, the carcass is easily pulled out. Smoothing the cervical vertebrae of the wire saw does not damage the vagina. 5. Pull the fetal head into the uterine cavity and show the middle finger into the fetal mouth. If the occipital bone is facing up, face down, pull the fetal head down to the lower edge of the pubic symphysis, and pull the fetal head upwards while the other hand presses the fetal head down on the lower abdomen to assist in the delivery. If the position of the fetal head is higher, the shoulder is embedded deeper, although the fetal neck can be touched, but the neck is difficult, and the head and shoulder oblique surgery can be performed. That is, the wire saw is cut from the side of the shoulder clavicle to the opposite side, and the arm is pulled out, the fetal head is pulled out, and the fetal hand is pulled, and then the carcass is pulled out. This method first comes out, and after the trunk is out, it is easier to pull out than the broken neck.

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