Excessive uterine contraction

　　What are the causes of strong uterine contractionsStrong uterine contractions have no special etiology, and are more common in experienced mothers.Incoordination of strong uterine contractions includes rigid uterine contractions and uterine spasmotic ring. Rigid uterine contractions are not due to functional abnormalities of the uterine muscle tissue, but are almost caused by abnormal external factors. For example, during labor due to obstruction, inappropriate use of oxytocin or blood infiltration of the uterine muscle layer by placental abruption can all cause the uterine muscle layer above the internal os of the cervix to appear rigid and spasmodic contractions. Uterine spasmotic ring. .

　　In patients with strong uterine contractions, the rhythm, symmetry, and polarity of uterine contractions are all normal, but only with excessive and frequent uterine contraction strength. If there is no resistance in the birth canal, the cervix will dilate rapidly within a short period of time, and delivery will end within a short period of time, with the total labor duration less than 3 hours, which is called acute labor, and is more common in experienced mothers.

　　Incoordination of strong uterine contractions includes rigid uterine contractions and uterine spasmotic ring. Rigid uterine contractions are not due to functional abnormalities of the uterine muscle tissue, but are almost caused by abnormal external factors. For example, during labor due to obstruction, inappropriate use of oxytocin or blood infiltration of the uterine muscle layer by placental abruption can all cause the uterine muscle layer above the internal os of the cervix to appear rigid and spasmodic contractions. The mother is usually restless, experiences persistent abdominal pain, refuses to be touched, the position of the fetus is unclear, and the fetal heart sound is unclear. Sometimes, signs of uterine rupture, such as pathological contractile ring and hematuria, may appear.

　　Uterine spasmotic ring is a ring-shaped stricture formed by spasmodic and uncoordinated contractions of certain parts of the uterine wall, which persists without relaxation. It often occurs at the junction of the upper and lower segments of the uterus, or in a narrow part of the fetus, commonly seen at the neck and waist of the fetus. It is often caused by mental tension, overfatigue, and inappropriate use of uterine contraction agents or rough obstetric handling. The mother may experience persistent abdominal pain, restlessness, slow cervical dilation,停滞 in the descent of the presenting part, and irregular fetal heart rate. Vaginal examination can feel the stricture ring, which is characterized by the fact that this ring does not rise with uterine contractions, unlike the pathological contractile ring.

　　Strong uterine contractions refer to the normal rhythm, symmetry, and polarity of uterine contractions, but with excessive uterine contraction strength. To prevent strong uterine contractions, pregnant women should pay attention to the following points.

　　1, Strengthen prenatal health care.

　　2, Actively treat malnutrition and chronic diseases, and discover and correct malpresentation in a timely manner.

　　3, Strengthen perinatal monitoring, provide a comfortable environment, provide psychological support, and eliminate ideological concerns and fear.

　　4, Pay attention to the rest, diet, and defecation of the mother, avoid excessive use of sedatives, and discover and deal with difficult labor factors in a timely manner.

　　5, Prevent the hazards caused by strong uterine contractions. Pregnant women with acute labor should be admitted to the hospital two weeks in advance to wait for delivery. During the hospital stay, it is strictly instructed not to leave the ward, and the dangers of acute labor are explained to the pregnant woman to obtain cooperation.

　　6, Prepare in advance for delivery and neonatal resuscitation.

　　Prevent postpartum hemorrhage and postpartum infection.

　　Patients with strong uterine contractions usually undergo routine obstetric and gynecological examinations, such as gynecological ultrasound, uterine examination, bimanual examination, vaginal examination, and cervical examination, where the vaginal examination can palpate the narrow ring.

　　Strong uterine contractions refer to the normal rhythm, symmetry, and polarity of uterine contractions, but with excessive uterine contraction strength. Strong uterine contractions occur during labor and there are no dietary restrictions. Pregnant women should pay attention to a reasonable diet and ensure a comprehensive and balanced nutrition.

　　Mothers with a history of strong uterine contractions and rapid labor should not travel long distances before the expected delivery date to avoid accidents, and if possible, they should be admitted to the hospital in advance to wait for delivery. It is not advisable to perform enema during labor. Prepare in advance for delivery and the treatment of neonatal asphyxia. Do not let the mother push down when the fetus is delivered. If there is no time for disinfection and the neonate falls to the ground, the neonate should be administered vitamin K1 intramuscularly to prevent intracranial hemorrhage, and the refined tetanus antitoxin 1500U should be administered as soon as possible. After delivery, the cervix, vagina, and vulva should be carefully examined, and if there are tears, they should be sutured promptly. If it is an unsterile delivery, antibiotics should be administered to prevent infection.

　　Once diagnosed with rigid uterine contractions, it is important to promptly administer uterine contraction inhibitors, such as 20ml of 25% magnesium sulfate added to 20ml of 5% glucose administered slowly by intravenous push or 1mg of epinephrine added to 250ml of 5% glucose administered by intravenous infusion. If the fetus dies in the uterus, ether inhalation anesthesia can be used. If it is due to obstructive reasons, an immediate cesarean section should be performed. If the rigid uterine contractions cannot be relieved after treatment, cesarean section should be considered.

　　In the case of uterine spasm ring, it is important to carefully find the cause of the uterine spasm ring and correct it in a timely manner. Stop all stimulations, such as prohibiting vaginal operations, discontinuing oxytocin, etc. If there are no signs of fetal distress, sedatives such as meperidine or morphine can be administered, which can generally eliminate abnormal uterine contractions. When the uterine contractions return to normal, vaginal assistance or waiting for natural delivery can be performed.

　　If the uterine spasm ring cannot be relieved after the above treatment, if the cervix is not fully dilated, the presenting part is high, or if there are signs of fetal distress, an immediate cesarean section should be performed. If the fetus dies in the uterus, and the cervix is fully dilated, ether anesthesia can be administered, and delivery can be performed through the vagina.