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Complications of abnormal fetal position
Common complications: Urethral cancer, post-abortion gynecological disease, female urethral cancer, cervical erosion, pelvic inflammatory disease, adnexitis, endometriosis, vulvitis, lipoma, vaginitis and candidiasis
Complications of abnormal fetal position
1. Premature rupture of membranes
When the head pelvis is not weighed or the fetal position is abnormal, there is a gap between the exposed part and the pelvis, and the anterior and posterior amniotic fluid communicates, resulting in uneven pressure of the anterior amniotic fluid sac. When the uterine contraction occurs, the fetal membrane bears too much pressure and breaks. Polyhydramnios, twin pregnancy and severe cervical laceration are also prone to premature rupture of membranes. Premature rupture of membranes is often a sign of abnormal delivery. It is necessary to find out whether there is headless pelvic dissymmetry or abnormal fetal position. Listen to fetal heart sounds immediately after rupture of membranes and pay attention to whether there is umbilical cord prolapse.
2. Delayed or blocked cervical dilatation
After labor, the cervical orifice of primipara has obvious regularity, that is, incubation period takes about 8 hours, which can make the cervical orifice expand to 3cm, and the active period takes about 4 hours, which can make the cervical orifice open completely. If you enter the active period, the cervical dilation speed of the parturient is less than 1.2 cm/h at the beginning or there is no progress in the labor process after the cervical dilation speed of the parturient, suggesting that there may be ineffective uterine contraction or uterine contraction fatigue, cervical edema, cervical tenacity and cervical scar, cephalopelvic disproportion, abnormal fetal position, macrosomia, middle pelvis or pelvic outlet plane stenosis.
3. Fetal distress
Due to prolonged labor, fetal hypoxia, decreased compensatory ability or decompensation may lead to signs of fetal distress (fetal heart rate > 160bpm or【小于】120bpm, irregular fetal heart rate, amniotic fluid pollution, fetal scalp blood pH【小于】7.24), so we should find out the causes of fetal distress and deal with it in time.
4. Maternal symptoms of systemic failure
Due to the prolonged labor process, the parturient is irritable and physically exhausted, and dehydration, metabolic acidosis and electrolyte disorder appear in severe cases. Intestinal peristalsis and bladder smooth muscle weakness caused by autonomic nervous dysfunction lead to flatulence and urinary retention, which should be found and corrected in time.
5. Fetal head descent is blocked
Cephalic presentation is not always able to deliver through vagina, and cephalic dystocia is not uncommon. After labor, once it is found that the descent of fetal head is blocked, the possibility of pelvic stenosis, abnormal fetal position, uterine contraction fatigue, abnormal soft birth canal, excessive fetal head, fetal malformation, uterine spasm stenosis ring and so on should be considered. Incubation period's fetal head does not enter the basin for a long time, so they should be alert to uterine fatigue and dissymmetry of the head and basin, and check whether the fetal head has cross-shame sign. Active stage and second stage of labor, fetal head descending speed position and occipital transverse position.
6. Abnormal uterine contractility.
The first difference is coordinated or uncoordinated uterine contraction fatigue or excessive strength. Then distinguish between simple uterine atony or other reasons. Secondary uterine atony is common clinically. When pelvis is narrow, cephalopelvic dissymmetry or fetal position is abnormal, uterine contraction is normal for a period of time at the beginning of labor. With the progress of labor, the decline of fetal head is blocked, which makes fetal head unable to cling to the lower uterine segment and cervical internal orifice, resulting in secondary uterine atony. Maternal mental stress or improper application of oxytocin can lead to uncoordinated uterine contraction. Such as twin pregnancy and polyhydramnios, uterine wall overstretch causes uterine contraction fatigue, etc. If it is not handled in time, the labor process can be prolonged. Uterine contraction is too strong, and the decline of fetal head is blocked, which may lead to threatened uterine rupture or even uterine rupture. Therefore, it is necessary to find out the abnormal contraction force of uterus in time, find out the reasons and deal with it in time.
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