(1) Postterm pregnancy: 2 weeks after the expected date of delivery, the placental function declines, and the fetus can suffer from hypoxia? Asphyxiation, even death? Therefore, it is advocated that pregnant women should be admitted to hospital at 4 1 week of pregnancy to prepare for induced labor and terminate pregnancy before 42 weeks of pregnancy?
(2) Pregnancy-induced hypertension syndrome: one of the common complications in the third trimester? Can you have convulsions when your condition develops seriously? Heart and kidney damage? Placental abruption? Fetal death in uterus, etc. Have a great influence on mother and fetus? When the disease is out of control, timely induction of labor and termination of pregnancy are the most fundamental treatments?
(3) Premature rupture of membranes: The longer the time between premature rupture of membranes and delivery, the greater the chance of infection? After 36 weeks of pregnancy, most patients with premature rupture of membranes can give birth within 12~24 hours. If you don't give birth for more than 24 hours, you should induce labor?
(4) heart disease? Chronic nephritis? Diabetes is not well controlled, or there is placental dysfunction and intrauterine growth retardation? Should induced labor be considered when the fetus is deprived of oxygen in the uterus?
(5) If the fetus is seriously deformed or dies in utero, it must be induced immediately after diagnosis?
(6) hydramnios? In particular, acute polyhydramnios, abdominal distension and compression symptoms should be induced by artificial rupture of membrane?
(7) oligohydramnios? The uterus tightly wraps the carcass, which can cause fetal distress and neonatal asphyxia. Do you need to induce labor in time?
Method of induced labor
Intravenous injection of oxytocin
Is it the most common method at present? Because everyone's sensitivity to oxytocin is very different, so use it from less to more? Adjust the concentration from slow to fast, pay close attention to uterine contraction and fetal heart changes? It should be noted that intramuscular injection or acupoint injection is not suitable for administration?
Artificial rupture of membrane
After artificial rupture of the membrane, amniotic fluid flows out, and the volume of the uterus shrinks, so that the fetal head clings to the inner mouth of the cervix, which reflexively causes uterine contraction and often enters the labor process quickly?
Stimulate nipple
Massage under the supervision of fetal electronic monitor? Rubbing one or both nipples stimulates sensory nerves and reflexively causes oxytocin secretion from hypothalamus-pituitary gland to cause uterine contraction?
prostaglandin
Is oral or vaginal medication simple? Effective?
Take Chinese medicine to induce labor? Castor oil scrambled eggs
Is it safe and effective to enema with hot soapy water after taking castor oil orally?
It should be noted that all this should be done under the guidance of a doctor?
Induction of labor by stripping membrane
Stripping the membrane is one of the methods of induced labor, overdue pregnancy, cervical maturity? If the fetal head has been fixed (connected to the basin) and the basin head is commensurate, how to induce labor in this way?
Pregnant women take bladder lithotomy position and routinely disinfect vulva (with soap in turn? Shimizu? New Gerald wipes vulva)? Can I use iodine for vagina and cervix? Alcohol disinfection? With iodine? Do pregnant women's vaginal mucosa feel "burning pain" during alcohol disinfection?
When peeling the membrane, the doctor only has the index finger? Put your middle finger into the vagina, gently dilate the cervix with your fingers, and then peel off the membrane between the cervix and the fetal sac to form a water sac. Prominent amniotic fluid sac can dilate the cervix and induce uterine contraction to induce labor. At this point, pregnant women may have slight pain. When finger reflexive dilatation of cervix causes uterine contraction, will there be back pain? Abdominal discomfort and vagina with a little mucus and bloody secretion (mixture of cervical mucus and capillary rupture bleeding on the stripping surface), less than menstrual blood?
If pregnant women are complicated with polyhydramnios; Or fetal malformation; Or placental abruption; Or partial placenta previa, vaginal bleeding is not much. Is it feasible to induce labor by artificial rupture of membrane after the formation of fetal cells?
12~24 hours after uncovering the film, there is still irregular shrinkage; Or there are still irregular contractions after artificial rupture of membrane for 6~ 12 hours, and oxytocin can be injected intravenously to induce contractions and promote delivery?
In the process of induced labor by peeling the membrane, pregnant women will feel uncomfortable more or less, but as long as they strengthen their cooperation with doctors, these uncomfortable feelings will soon pass?
Oxytocin induced labor
Oxytocin is a drug that can cause regular uterine contraction? Is it often used to induce labor or in the second and third trimester of pregnancy? The method of induced labor by oxytocin is to stimulate the uterus with oxytocin and other drugs after formal delivery. How to strengthen contractions?
Oxytocin acts on uterine muscles, causing them to contract intermittently. The ideal contraction caused by oxytocin is that each contraction lasts for 30-50 seconds, and the contraction interval is 2-4 minutes? If the duration of each contraction is less than 30 seconds and the interval between contractions is more than 5 minutes, its effect of promoting uterine expansion and reducing fetal presentation is extremely weak? However, if the duration of uterine contraction exceeds 60 seconds (tension contraction), fetal distress may occur due to uterine muscle wall ischemia and intrauterine fetal hypoxia during uterine contraction. The duration of tonic uterine contraction is too long, and repeated occurrence can induce uterine rupture? Therefore, when intravenous infusion of oxytocin, we should strictly control the input speed, that is, control the infusion amount of oxytocin per unit time? Maintain contractions at a level that is both effective and harmless to mother and child?
Oxytocin is usually diluted with 5%~ 10% glucose solution. Generally speaking, oxytocin l~2 units are added to 200ml glucose, that is, the concentration is 0.5%~ 1%. At first, I injected a dozen drops intravenously every minute, and then gradually increased to about 30 drops per minute?
Before oxytocin drops into the vein, pregnant women should make the following preparations:
(1) What is net flow? Urine;
(2) clean the limbs (mostly left upper limbs) of intravenous infusion;
(3) The bed surface is flat and the pillow height is moderate;
Take off the sleeve of the venipuncture limb? If you just push the cuff up, you may "strangle" the limb too tightly, thus affecting the blood supply and intravenous infusion of oxytocin?
The position of the infusion limb can often affect the dripping speed, so the limb should be kept in the right position continuously? Never move your limbs at will to prevent the needle tip from puncturing the blood vessel wall, so that the liquid medicine can penetrate into the tissues around the blood vessel and cause the limbs to swell? What should I do if I find that my limbs are swollen during infusion? If you have pain, you should report it to the doctor in time so that you can adjust it at any time and re-puncture if necessary?
During infusion, the best position for pregnant women is the left lateral position. When listening to the fetal heart, can I temporarily take the supine position? In order to avoid hypovolemia and "supine hypotension syndrome" caused by the compression of abdominal aorta and inferior vena cava by pregnant uterus?
When oxytocin induces regular contractions, it should be kept still even during contractions, especially the static limbs. At this time, you should take a deep breath, or gently massage the lower abdomen and lower back with the limbs on the unfused side to relieve discomfort?
Is there a medical staff watching the progress of labor when oxytocin is injected intravenously? Listen to the fetal heart every 10~ 15 minutes, and record the contractions every half hour? Examiners can feel the duration and interval of contractions by putting their hands on the uterine body, and adjust the dropping speed and concentration of oxytocin at any time according to the contractions? Measure your blood pressure every 1 hour, and check your anus every 2~4 hours (how big is the cervix)? What if pregnant women have a headache during intravenous injection of oxytocin? Dizziness and panic? Hold your breath? At a loss Gross? Vomiting, severe abdominal pain? Abnormal vaginal flow and fetal movement should be reported to the doctor immediately, so that the doctor can take measures as soon as possible to prevent accidents?
Necessity of induced labor
Induced labor includes two categories: mid-term induced labor and late induced labor? Induced labor in 3-6 months of pregnancy is called mid-term induced labor and termination of pregnancy? Is the delivery mode of drug induced labor late after 28 weeks of pregnancy? Can induced labor help the fetus get rid of the bad environment as soon as possible and improve the survival rate of newborns?
Mid-term induced labor is mainly used to treat diseases or family planning, such as pregnant women suffering from hypertension? Nephritis? Tuberculosis and other diseases, continue to be pregnant is not good for the mother, or unplanned pregnancy? Unmarried pregnancy, etc?
Late induced labor is mainly used in the following situations:
Expired pregnancy? More than 2 weeks after the expected date of delivery, B-ultrasound indicates that the placenta has no function, which is unfavorable for the fetus to continue pregnancy?
Pregnancy induced hypertension syndrome? When the pregnancy is 37 weeks, is the treatment effective and should it induce labor? It should be less than 37 weeks pregnant, but the patient's condition has not improved significantly after treatment?
Pregnancy complicated with heart disease? Chronic nephritis? Diabetes? Tumor?
Premature rupture of membranes, automatic rupture of membranes for 24 hours without labor? The longer the time from rupture to delivery, the greater the possibility of secondary intrauterine infection. When the sheep is short of water, the uterus tightly wraps the carcass, which can prolong the labor process?
Amniotic fluid? In particular, acute polyhydramnios, abdominal distension and compression symptoms should be induced by artificial rupture of membrane?
Oligohydramnios? The uterus tightly wraps the carcass, and the carcass gathers, which is prone to fetal distress and neonatal asphyxia?