Thursday 6 March 2008

Excessive uterine contraction

Excessive uterine contraction
[Summary]



Including the production of uterine contractility, and the abdominal muscle contraction of the diaphragm muscle and anal contraction, with the main uterine contractility. In the delivery process, uterine contraction of the rhythm, symmetry and not normal polarity or intensity, frequency changes, known as abnormal uterine contractility. Clinical more production, or because of fetal abnormalities form factors obstruction dystocia, the fetus through the birth canal resistance increased, resulting in production of secondary abnormalities. Abnormal uterine contractility of the weak and divided into uterine contractions in the uterine contraction strong two categories, and each category, for the coordination and uncoordinated contraction of the uterus and uterine contraction.



[Treatment]




(1) Coordination of excessive uterine contraction

A maternal history of radical production in the pre-production period of 1 to 2 weeks before it is not appropriate to leave out, so as to avoid accidents and conditions should be hospitalized early production. After the enema not labor. Chachan well ahead of neonatal asphyxia and rescue preparations.勿使maternal when the baby is delivered downward breath. If there was not enough time to disinfect and radical production plunged newborn, newborn should intramuscular injection of vitamin K1 prevention of intracranial hemorrhage, and early anti-tetanus toxin injection Refining 1500 U. Postpartum carefully examined cervix, vagina, vulva, and if so torn timely suture. If it is not disinfected Chachan, should be given antibiotics to prevent infection.

(B) uncoordinated contraction of the uterus too

1. Ankylosing uterine contractions when diagnosed with ankylosing spondylitis, a uterine contraction, it is timely to contractions inhibitors, such as magnesium sulfate 20 ml 25% by adding 20 ml of 5% glucose slow intravenous injection, or 1 mg epinephrine added 250 ml of 5% glucose in the veins Drip. If it is the obstruction of reasons, the trip should immediately cesarean section. If intrauterine fetal death can be inhaled ether anesthesia. Following the above address, if still not lifted ankylosing uterine contraction, consideration should be given to cesarean section.

2. Narrow ring of uterine cramps should be seriously looking for uterine cramps result of the reasons for the narrow ring, promptly gave correct. Stop all stimulation, such as the prohibition of the operation of the vagina, such as oxytocin suspended. Without signs of fetal distress may be given sedatives such as morphine or meperidine, the general will remove abnormal contractions. When resume normal uterine contractions, vaginal delivery or feasible for natural childbirth. If the above treatment of uterine cramps narrow ring can not be relieved, I did not open the whole Palace, the first disclosure of the child, or with signs of fetal distress, should be immediately Bank cesarean section. If intrauterine fetal death, I have been open the whole Palace, feasible ether anesthesia by vaginal delivery.


[Clinical]




(1) Coordination of excessive uterine contraction

Uterine contraction of the rhythm, symmetry and polarity are normal, and only a strong uterine contractility, and the frequency. If the birth canal without resistance, cervical rapidly in a short time a whole, and the end of maternity leave in a short time, the total labor less than three hours, as radical production. The maternal多见.

Impact on the mother and infant

(1) the impact of the mother: the too frequent contractions, labor and fast, and can be caused by maternal early cervical, vaginal and perineal laceration. Chachan, too late disinfection of puerperal infection. Postpartum uterine muscle fibers shrink-prone bad retained placenta or postpartum hemorrhage.

(2) the impact of fetal and neonatal: contractions impact of the stronger than the frequency of uterine blood circulation placenta, fetal hypoxia in the womb, prone to fetal distress and neonatal asphyxia or even death. The baby is delivered fast, and the fetal head in the birth canal, the pressure on the sudden lifting can be caused by neonatal intracranial hemorrhage. Too late Chachan, newborn vulnerable to infection. If plunged induced fractures, trauma.

(B) uncoordinated contraction of the uterus too

1. Ankylosing uterine contraction ankylosing uterine contraction is not abnormal uterine muscle tissue, almost all caused by abnormal external factors, such as labor occurred after childbirth due to obstruction, or inappropriate use of oxytocin, uterine or placental abruption blood infiltration muscle, the mouth can cause cervical over part of the myometrium in ankylosing spastic contraction. Maternal irritability, persistent abdominal pain, according to resist. Inconsistent with the wrong position unclear, fetal heart rate Tingbuqing. Sometimes, there may be pathological shrink-Central, hematuria, and other signs of uterine rupture threatened.

2. Uterine cramps stenosis Central (constriction ring) uterine wall unit muscle spasm was uncoordinated contraction of the ring formed by narrow, continued to relax, known as uterine cramps stenosis ring. Multi-junction in the womb, from top to bottom, is also available at the Department of carcass of a narrow, fetal neck, the common fetal lumbar (Figure 1).



(1) narrow ring around the fetal neck (2) the narrow ring prone position

Figure 1 of uterine cramps narrow ring

More because of mental stress, fatigue and improper application or contraction of gross due to obstetric treatment. Maternal persistent abdominal pain, irritability, dilated cervix slow decline of the fetus exposed to stagnation, and fetal heart rate, fast, slow. Vaginal examination can be touched narrow aspect of this feature is not part with contractions increased, and pathological shrink-ring different.

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