excision

Debridement is obstetrics. The purpose of the destructive surgery is to destroy or separate the carcass, so that the size of the fetus is reduced to facilitate delivery from the vagina. In modern obstetrics, due to the strengthening of maternal and child health work and the improvement of obstetrics, the dystocia can be treated early, and the dystocia is rarely used. It is only suitable for stillbirths, deformed fetuses and very few special cases. There are many types of destructive surgery, and it is necessary to determine the way of performing surgery in combination with clinical specific conditions. Commonly used are craniotomy, decapitation, decontamination and spinal surgery. The instruments used include long scissors, craniotomy, broken cramps and broken hooks. Debridement is to remove the chest or abdominal organs of the fetus and reduce the volume of the fetus for delivery from the vagina. Treating diseases: teratoma Indication Decontamination applies to: 1. Neglecting the transverse position, the fetus has died, the position of the fetal neck is high, the chest and abdomen are deeply embedded in the pelvis, and even into the vagina, it is not easy to perform the decapitation. 2. Fetal chest, abdomen has tumors, abnormal organ development or ascites and other obstruction of childbirth. 3. Conjoined teratoma. Contraindications 1. There are signs of uterine rupture of the aura. 2. The pelvis is obviously narrow or deformed. 3. Gongkou is not close to full or not open. Preoperative preparation Disinfect long scissors, placenta pliers or oval clamps, and single-leaf wide vaginal hooks. Surgical procedure 1. Cut the chest Strictly disinfect the vulva and prolapsed fetal upper limbs, catheterization, vaginal examination to determine the position of the chest and abdomen, the assistant will pull the hand out to the side of the fetal head, the operator holds the long scissors on the right, and puts it into the uterine cavity under the guidance of the left hand and the cover. Cut the intercostal space and muscles. If the chest is embedded in the vagina, the anterior and posterior walls of the vagina can be pulled with a single-leaf wide vaginal pull hook to expose the lower part and operate under direct vision. 2. Remove the internal organs Enlarge the intercostal incision, use the placenta forceps or the oval clamp to extend from the incision into the thoracic cavity, and clip out the thoracic organs. If necessary, you can pass through the transverse iliac crest to the abdominal cavity and clip the abdominal internal organs. 3. Pull out the fetus After the fetal viscera is removed, the carcass is shrunk, and the upper limbs are pulled out, and the carcass can be folded and delivered. You can also use your fingers to reach into the incision, hook the abdomen down and pull the lower limbs out of the lower part, and then deliver the fetus according to the breech traction. 4. Check the uterus, cervix, vagina After the placenta is delivered, the uterus, cervix, and vagina should be examined. If there is any damage, treat it immediately. complication 1. The birth canal is damaged and the uterus is broken. 2. Postoperative infection.

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