Abnormal labor force

　　The following points should be noted:

　　(Zero) Mental factors: It often occurs when the mother is too nervous or has a fear of childbirth, leading to dysfunction of the cerebral cortex and affecting the normal regulation of uterine contractions.

　　(One) Uterine factors: Overextension of the uterine wall, such as twins, polyhydramnios, macrosomia, poor uterine development, or malformation, can all affect uterine contractions.

　　(Two) The presenting part cannot closely adhere to the cervical part: It is not easy to cause uterine contractions reflexively, and it is common in malpresentation, breech position, and transverse position, etc.

　　(Three) Drug effects: The use of large amounts of sedatives during labor inhibits uterine contractions.

　　(Five) Endocrine disorders: Insufficient estrogen or oxytocin at the end of pregnancy, or excessive progesterone, reduced acetylcholine, or decreased sensitivity of the uterus to acetylcholine can all affect uterine contractions.

　　(Six) Other factors: After childbirth, the mother may be excessively tired, eat less, or use abdominal pressure too early during the late stage of the first stage of labor, or the bladder may be full, affecting the descent of the presenting part of the fetus, all of which can lead to weak uterine contractions.

　　It is easy to cause serious perineal injury, placental or amniotic membrane retention, postpartum hemorrhage, and infection. Due to frequent uterine contractions, the placental blood circulation is affected, which is easy to cause fetal distress, stillbirth, or neonatal asphyxia. In addition, if the fetal head passes through the birth canal too quickly, it can also cause intracranial injury. If attention is not paid, the fetus may be injured when it is born, and there may be umbilical cord rupture and bleeding.

　　Common manifestations of dystocia include the following two types:

　　1. Coordinated uterine contraction hypotonia: Uterine contractions have normal rhythm, symmetry, and polarity, but the contraction force is weak.

　　2. Incoordination of uterine contraction hypotonia: Uterine contractions lose their normal rhythm, symmetry, and polarity, especially the polarity, and even the contraction waves reverse. They cannot produce a downward force, although the intrapelvic pressure increases with uterine contractions, the presenting part does not descend, and the cervix cannot dilate, which is an ineffective contraction.

　　When women are pregnant for the first time, they may experience anxiety, lack of energy, or problems with uterine contractions due to many reasons. This is because dystocia has occurred, and this disease must be prevented in advance. Only by preventing it can the physical pain be reduced, and it can be easier and faster to deliver the baby. Today, I will share with everyone the methods of preventing dystocia.

　　Step-Method:

　　1. It is very important to relax the mind, as many mothers are in a state of fear due to tension. In fact, with the development of modern medicine, giving birth is a minor matter and there is no need to be anxious. Even if it is painful, it is just a moment, and the pain will go away after giving birth.

　　2. It is very important to eat more, because only by eating more can there be enough strength during the labor process. It can be said that giving birth is a labor-intensive job that requires a lot of energy. When full-term, some congee made with sea horse, millet, and brown sugar can be eaten. This congee has the effects of regulating the menstrual cycle and promoting labor.

　　3. It is very important to go to the hospital regularly for obstetric examinations and to pay attention to whether there is an asymmetry between the head and the pelvis. This is a very necessary examination to prevent dystocia. When problems are found, take the correct solution in a timely manner.

　　General examination should pay attention to general development, such as short stature, abnormal fetal position, the fetal head not entering the pelvis before labor in primiparas, or having a hanging abdomen, all indicate that the pelvis may be narrow, and limping, the pelvis may be oblique. Pelvic measurement includes the sacral-pubis diameter

　　Normal uterine contractions have a certain rhythm, polarity, and consistency, with corresponding intensity and frequency. Abnormal contractions are called dystocia, which is divided into three types: hypotonia, irregularity, and hyperactivity, with hypotonia being the most common. Patients with dystocia should pay attention to their diet:
　　1. During the first stage of labor, due to the relatively long duration, the mother's sleep, rest, and diet may be affected by uterine contractions. In order to ensure that there is enough energy to complete childbirth, the mother should try to eat as much as possible. Foods mainly include semi-liquid or soft foods such as egg noodles, cakes, bread, congee, etc.
　　2. As the second stage of labor approaches, due to frequent uterine contractions, increased pain, and increased consumption, the mother-to-be should try to consume some liquid foods such as fruit juice, lotus root powder, brown sugar water, etc. during the intercontraction period to replenish energy and help the delivery of the fetus. The food during delivery should be chosen to be easily digested and absorbed, such as high-sugar or starch foods, to quickly replenish energy.
　　3. It is not advisable to eat greasy, high-protein foods that take too long to digest.

　　Firstly, check in detail whether there is any birth obstruction, and appropriate treatment should be given if there is obstruction. For those without obstruction, more comfort and encouragement should be given, attention should be paid to nutrition and rest, and sedatives should be given if necessary, and attention should be paid to water and electrolyte balance. For those with labor lasting more than 24 hours or membranes ruptured for 12 hours, antibiotics should be given to prevent infection. After the above treatment, after several hours of rest, uterine contractions can usually improve and the delivery can be completed smoothly. If ineffective, the following methods can be tried to stimulate and strengthen uterine contractions:

　　(One) Enema or Urinary Catheterization: Enema with hot soap water can promote uterine contractions. For those who have difficulty urinating, urinary catheterization can be performed.

　　(Two) Acupuncture: Acupuncture at the triple yin intersection and Hegu points, using an exciting technique, or inject vitamin B12 12.5-50mg at the Hegu point.

　　(Three) Artificial Rupture of Membranes: For those with the fetal head engaged and the cervix dilated 2-3cm without malpresentation, artificial rupture of the membranes can be performed to make the presenting part tightly adhere to the lower segment of the uterus and the cervix, to reflexively induce uterine contractions. The time for rupture of membranes should be selected between two contractions.

　　(Four) Oxytocin intravenous drip can cause strong uterine contractions, and it is strictly forbidden to use a large amount at one time to avoid causing tetanic uterine contractions, leading to asphyxia and death of the fetus, which may cause uterine rupture. It must be ruled out before use that there is no malpresentation or malposition. It is taboo for those with floating fetal heads. The usage is as follows:

　　Oxytocin 2.5u or 5u added to 500ml of 5% glucose for intravenous drip. Start with 10-15 drops per minute, and if there is no increase in uterine contractions, it can gradually increase, but it is best not to exceed 40 drops per minute. Pay close attention to uterine contractions, descent of the presenting part, and changes in fetal heart sound during infusion. If the contractions are too strong or the fetal heart rate changes, the infusion should be slowed down or stopped.

　　After the above treatment, uterine contractions can usually become stronger, the cervix gradually opens, and the fetus can be delivered smoothly. If it is ineffective, consider surgical assistance. Whether it is vaginal delivery or cesarean section, attention should be paid to prevent postpartum uterine atony hemorrhage.