Abnormal childbirth

　　Due to any abnormality in labor force, birth canal, and fetus, causing obstruction in the process of childbirth and difficulty in delivering the fetus, it is called abnormal childbirth, commonly known as dystocia. Then, what are the causes of abnormal childbirth? Below, experts introduce the causes of abnormal childbirth:

　　1, Force of labor

　　Force of labor is the driving force of childbirth, including uterine contraction, abdominal and diaphragmatic contraction, and anal and levator ani contraction. Among them, uterine contraction is the main factor.

　　2, Abnormal birth canal

　　Abnormal birth canal includes abnormal bony birth canal and abnormal soft birth canal. It can cause the fetus to be unable to be delivered, and clinically, abnormal bony birth canal is more common.

　　3, Abnormal fetal position

　　One of the common causes of dystocia. During childbirth, the occiput anterior position accounts for about 90%, while malpresentation accounts for about 10%, among which abnormal fetal head position is the most common: persistent occiput, persistent occiput posterior, face presentation, oblique position, anterior malposition, etc., accounting for about 6%-7%. The breech presentation accounts for about 4%, and shoulder presentation is very rare.

　　4, Excessive anxiety and fear

　　Anxiety is a common negative emotion, a complex psychological stress response that individuals produce out of fear and concern about potential threats they face.

　　If abnormalities in childbirth are not detected or treated in a timely manner, both the mother and child can suffer varying degrees of damage. Below, experts introduce the complications of abnormal childbirth:

　　Firstly, the mother can suffer from

　　1, Systemic failure can occur after childbirth bleeding and infection.

　　2, Obstructed labor can cause tetanic uterine contractions, which may cause uterine rupture.

　　3, If the anterior part of the fetus compresses the soft tissue of the birth canal for a long time, it can lead to tissue necrosis and the formation of vesicovaginal or rectovaginal fistula.

　　Secondly, regarding the fetus

　　1, The opportunity for cesarean section increases, and the opportunity for fetal injury also increases, such as intracranial hemorrhage and fracture.

　　2, Premature rupture of membranes can lead to umbilical cord prolapse or infection.

　　3. If the fetus is compressed in the birth canal for too long or due to complications such as umbilical cord prolapse, it is easy to suffer from asphyxia, even death.

　　Any abnormality in labor force, birth canal, or fetus can cause difficulties in the delivery process and the baby's delivery. The main clinical manifestations of dystocia include slow progress of labor, failure of the presenting part to descend, slow opening or insufficient opening of the cervix, cervical edema, urinary retention, etc.

　　Pregnant women should do a good job of examination, which can greatly reduce the incidence of abnormal delivery. Abnormalities in the fetus and birth canal can usually be found during prenatal examinations. For those with malpresentation, efforts should be made to correct them; for those with narrow pelvis, an initial estimate of the delivery method can be made according to the degree of narrowing. Good pre-delivery explanations, correction of anemia, improvement of nutrition, prevention and treatment of pregnancy-induced hypertension and other pregnancy complications, etc., are all sufficient to enhance the health of the mother and child, and benefit the normal progress of pregnancy and delivery.

　　Abnormal delivery refers to the situation where any abnormality in labor force, birth canal, or fetus causes difficulties in the delivery process and the baby's delivery. Then, what kind of laboratory tests are needed for abnormal delivery? The following expert introduces the laboratory tests that need to be done for abnormal delivery:

　　1. The first prenatal examination (around 12 weeks of pregnancy).The prenatal examination during this period is mainly to verify the pregnancy status and get a preliminary understanding of the embryo. Necessary examination items include: height, weight, gynecological examination, routine blood test, urine routine, vaginal discharge, syphilis screening, B-ultrasound examination. For those who have not had premarital or prenatal examinations before, it is necessary to add screening for thalassemia, and for those who keep pets at home, it is necessary to add parasitological examination. Expert reminder: The examination items of the first prenatal examination are relatively the most, which is to comprehensively check the health status of the expectant mother.

　　2. The second prenatal examination (at 16 weeks of pregnancy).The items of the second prenatal examination include: physical examination: body temperature, pulse, respiration, blood pressure, weight, fundal height, physical examination (edema, etc.); laboratory tests: routine blood test, urine routine and Down syndrome screening; auxiliary examination: Doppler fetal heart sound. Expert reminder: The most important item in the second prenatal examination is the Down syndrome screening, which requires an absolute fasting of more than 12 hours before blood collection.

　　3. The third prenatal examination (at 20 weeks of pregnancy).The items of the third prenatal examination include: physical examination: body temperature, pulse, respiration, blood pressure, weight, fundal height, physical examination (edema, etc.); laboratory tests: routine blood test, urine routine; auxiliary examination: Doppler fetal heart sound, obstetric color Doppler ultrasound, screening for major congenital malformations. Expert reminder: The most important item in the third prenatal examination is the ultrasound screening for major congenital malformations. It is recommended to move around more before the screening to help the baby's position reach the best, and it is appropriate to eat a few pieces of chocolate, which can make the baby more active and beneficial for the screening for congenital malformations.

　　4. The fourth prenatal examination (at 24 weeks of pregnancy).The fourth prenatal examination includes: physical examination: body temperature, pulse, respiration, blood pressure, weight, fundal height, physical examination (edema, etc.); laboratory tests: routine blood test, urine routine and oral glucose tolerance test; auxiliary examination: Doppler fetal heart sound. Expert reminder: This is a routine examination, and it can also be used for screening for major congenital malformations.

　　5, the 5th prenatal examination (28th week of pregnancy), the 6th prenatal examination (30th week of pregnancy).The items of the 5th and 6th prenatal examinations include: physical examination: body temperature, pulse, respiration, blood pressure, weight, uterine height, physical examination (edema, etc.); laboratory tests: blood routine, urine routine; auxiliary examinations: obstetric color Doppler ultrasound, Doppler fetal heart sound listening. Experts remind: Starting from 28th week of pregnancy, prenatal examinations change to every two weeks. The 5th and 6th prenatal examinations are routine checks and do not require excessive tension.

　　6, 7th prenatal examinations (32nd week of pregnancy).The items of the 7th prenatal examination include: physical examination: body temperature, pulse, respiration, blood pressure, weight, uterine height, physical examination (edema, etc.); laboratory tests: blood routine, urine routine; auxiliary examinations: pelvic measurement, pelvic examination, Doppler fetal heart sound listening. Experts remind: This time is a routine examination plus pelvic measurement and pelvic examination. Pelvic measurement is mainly to detect whether the shape of the pelvis is abnormal and whether the dimensions are sufficient to determine whether the fetus can be delivered vaginally smoothly.

　　7, the 8th prenatal examination (34th week of pregnancy).The items of the 8th prenatal examination include: physical examination: body temperature, pulse, respiration, blood pressure, weight, uterine height, physical examination (edema, etc.); laboratory tests: blood routine, urine routine, B-hemolytic streptococcus culture; auxiliary examinations: obstetric color Doppler ultrasound, pelvic measurement, pelvic examination, Doppler fetal heart sound listening. Experts remind: In addition to routine examinations, this time pelvic monitoring and pelvic examination can also be performed. The special examination is B-hemolytic streptococcus culture, which has no effect on adults but may infect B-hemolytic pneumonia and sepsis in neonates, especially those delivered vaginally, during passage through the birth canal.

　　8, the 9th prenatal examination (36th week of pregnancy).The items of the 9th prenatal examination include: physical examination: body temperature, pulse, respiration, blood pressure, weight, uterine height, physical examination (edema, etc.); laboratory tests: blood routine, urine routine, liver function, kidney function, HIV; auxiliary examinations: fetal heart monitoring, Doppler fetal heart sound listening. Experts remind: In addition to routine examinations, this time there will also be laboratory tests for liver function, kidney function, and HIV.

　　9, the 10th prenatal examination (37th week of pregnancy).The items of the 10th prenatal examination include: physical examination: body temperature, pulse, respiration, blood pressure, weight, uterine height, physical examination (edema, etc.); laboratory tests: blood routine, urine routine; auxiliary examinations: obstetric color Doppler ultrasound, fetal heart monitoring, Doppler fetal heart sound listening, prenatal assessment (pelvic measurement). Experts remind: This time, in addition to routine examinations, the most important item is prenatal assessment (pelvic measurement). The size and shape of the pelvis play a decisive role in the smoothness of delivery. If the size and shape of the pelvis are abnormal and not suitable for the fetus, the descent of the fetus may be obstructed, leading to dystocia. Therefore, pelvic measurement must be taken during prenatal examination.

　　10, 11th to 13th prenatal examinations (38th to 40th weeks of pregnancy).The last three prenatal examinations include: physical examination: body temperature, pulse, respiration, blood pressure, weight, uterine height, physical examination (edema, etc.); laboratory tests: blood routine, urine routine; auxiliary examinations: fetal heart monitoring, Doppler fetal heart sound listening.

　　Examination of the birth canal, general physical examination, and other measures are also very critical.

　　If there is no gas passage within 24 hours after childbirth, radish soup can be taken to promote gas passage, or Simo Decoction and Shrimp Radish Soup can be taken. It is recommended to turn over on the bed to promote peristalsis. Before gas passage occurs within the first 24 hours after surgery, no food or water should be taken, and only a small amount of water can be used to moisten the lips; after gas passage, non-milk, non-sugar liquid foods can be taken, and normal diet can be resumed after defecation, such as lean meat, milk, fresh vegetables and fruits, various soups, and avoid eating stimulating and cold foods.

　　Attention should be paid to the postpartum care of women with abnormal childbirth, and observe for vaginal bleeding, intestinal adhesions, gastrointestinal problems, etc. Diet should avoid spicy and greasy foods.

　　When abnormal childbirth occurs, the first step should be to find the cause, weigh it according to its importance, and decide on the method of treatment after a comprehensive assessment. The principles of treatment are divided into the following two major categories:

　　1. Conservative therapy: When there is insufficient uterine contraction, prolonged labor, but no severe mechanical obstruction, and it is estimated that the fetus can be delivered vaginally, conservative therapy should be the main approach. For those with prolonged labor and poor rest, fatigue or exhaustion is likely to occur, so more mental comfort and encouragement should be provided, and 10-15ml of chloral hydrate mixture can be taken orally, or 50mg of meperidine or promethazine intramuscularly, or 10mg of diazepam intramuscularly. For those who cannot eat, fluid replacement should be administered. During the waiting period, close observation should be made of the descent of the presenting part and the dilation of the cervix, and the fetal heart sound should be listened to frequently. Most women can deliver smoothly after getting enough rest. If the progress of labor is slow, and the woman shows exhaustion or the fetal heart sound changes, positive measures should be taken to end labor according to the situation, and it is not advisable to be overly conservative.

　　2. Actively handle severe mechanical obstruction such as malpresentation of the pelvis and fetus, or (and) malpresentation, leading to the inability to deliver the fetus or any emergency situation that poses a threat to the safety of the mother and child during childbirth. If there are signs of fetal distress, cord prolapse, or uterine rupture, positive measures should be taken to end childbirth.

　　The method of ending childbirth should be determined according to the degree of uterine contractions, the extent of cervical dilation, the size of the pelvis, the position of the fetus, the height of the presenting part, the size and condition of the fetus, the general condition and age of the mother, the number of deliveries, and the degree of attention to the fetus. It can be divided into cesarean section or vaginal delivery (spontaneous or assisted by surgery).