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Is over 5 months pregnant white-collar Beauty Gillian since last week fetus was identified as B-type ultrasonic after breech to a reversal of past joy of the mother, became worried about it. She had not afraid of giving birth off, more worried about whether the safety of the baby come to earth, so long ago hung up the maternity hospital out-patient number of experts, Professor Zhang.
Professor Zhang warmly received by the doctor from afar, and Gillian, introduced the first to breech the many products may cause harm. Professor, breech presentation is one of the most common abnormal fetal position, even though the incidence of only about 5% of total number of deliveries may be close to labor dystocia rate dystocia of the total number of 1 / 5. Breech vaginal delivery is not only likely to cause umbilical cord prolapse, fetal head after a difficult, can cause fetal asphyxia, injury and death. Although cesarean delivery can reduce the morbidity and mortality of the fetus, but there are many negative factors after cesarean section. Thus, strengthening prenatal, to promote transfer child or fetal position corrected by artificial means, to minimize the rate of breech presentation in labor is the most critical.
After being identified as the breech fetus should be how to do it? Zhang stressed that occurred within 28 weeks in breech pregnancy, pregnant women and their families do not have to worry, go with the flow as possible. Because at this relatively high intrauterine amn


iotic fluid, fetal position variable, the natural high slew rate, no hurry to correct fetal position. 30 weeks pregnant or more is still breech, they must take active measures to turn the tires. This is because with the gradually extend the period of pregnancy, breech presentation significantly decreased the natural rotation rate of the reason.
Correct fetal position on artificial methods, there are several to choose from: moxibustion bilateral Yam points method: identify the points, moxibusti or 2 times a day, 7 Tianyi course of treatment. This method can increase fetal movement, the breech converted into first place. supine knee chest correction method: pregnant women to take knee-chest supine, the hip can leave the maternal fetal pelvis, the focus is changed when the baby can turn into a head position. Is the daily morning and evening, every 15 minutes, 7 Tianyi course of treatment. foreign Deflection correction method: by a doctor pregnant belly with both hands in the implementation of a corrective surgery, the operation in different ways, specific to a pregnant woman, the use of which approach may be appropriate by doctors.
Finally, take care of Zhang Jiao said, just over 23 weeks of your pregnancy, there are naturally turn tires possible fetal position is not currently a need for correction. But it should give full attention to rest, sleep desirable lateral position, prompting the fetus back up, which will help naturally turn tires. And regularly to the hospital for referral to the correct guidance of a doctor and master the favorable opportunity of correcting fetal position. If not corrected near the antenatal fetal position, be sure to hospital to be produced in advance, when the doctors decided to end the situation according to the actual mode of delivery, to ensure that mother and child safe. Gillian got up to leave, profuse in her acknowledgments.
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Nursery[Fujian - Xiamen City] Maternity Hospital, Siming District, Xiamen City
Episiotomy
Along the production process abroad as general surgery accounted for the proportion of vaginal delivery: 20%; while the domestic production process as smooth routine operation accounted for the proportion of vaginal delivery: 90%.
Reason
7 days can reduce the occurrence of late postpartum perineal damage, healing complications such as suture and to prevent perineal tearing and protect the pelvic floor muscles and surgical incision that easy to repair and heal better.
First child in general, 90% of people will have different degrees of laceration. Mild healing laceration is very easy, easier to heal than lateral, but I just said it is not a conventional lateral shear, to weigh our delivery staff is a cut lateral tear in order to avoid more serious injury. And in doing lateral, we are rushed to do a perineal nerve tissue anesthesia, lateral to suture the wound, and to restore its original anatomical structure, it would not affect second child. After the perineal wound healed, it will not affect the sex life. skewed cut: the cut skewed 45. Angle.
median incision: a midline incision in the perineum.
incision in the side of the first cut is skewed 15. A 30. Angle, to 2cm from the anal sphincter scissors at the direction of change, so that the outside edge to point.
side of the cut: the cut skewed 90. Angle.
Clinical use is generally skewed cut, side cut is no longer used, it is usually called lateral incision has not adopted refers skewed, it is usually said in terms of lateral cut refers skewed.
Indications
1. Primipara breech delivery or perineal body high, hard and tight organization, dysplasia or inflammation, edema, or acute intrapartum perineal body not fully expanded, it is estimated will occur when the fetal head was delivered 'laceration who'.
2. Mild cephalopelvic disproportion.
3. Fetal distress requiring immediate expulsion of the fetus or pregnancy complications, complications, those who need to shorten the second stage of labor.
4. Forceps or when fetal aspiration midwifery.
5. The maternal perineal body scars, of perineal dilation.Regular disinfection of the vulva
Anesthesia
1. Local anesthesia: with 0.25%-o. 5% procaine or o. 5% lidocaine 10-20ml to the intended site of skin incision and vaginal dry film fan to do under the infiltration injection.
2. Pudendal nerve block anesthesia: pudendal nerve from the side around the ischial spine later on, he three branches located in the vulva. Blockade hand index finger into the vagina to do within the tactile guide ischial spines, hand with the inhalation of o. 5% lidocaine 20m1 syringes with long needles, the first between the ischial tuberosity and anal injection of a small Picchu, and then vertically into the needle slightly inferior to the ischial spine, Withdrawing without blood, injection of 10m1 liquid, and then the same as local anesthesia, while back side of injection needles.The location of episiotomy1. Cut the perineum: To facilitate the operation, the general choice for the left perineal incision. Shown to the left, middle finger into the vagina Chung, jump scheduled parts of the vaginal wall incision, the assistant pushed outward to tighten the skin, right hand holding scissors, after the contraction when combined perineal midline from the left side of 45. Direction (the direction of the ischial tuberosity) cut 4-5cm. Perineum of 60 counterparts highly inflated. A 700 angle, after the expulsion of the fetus can naturally restore a 45 degree angle.
2. Bleeding: after perineal incision with gauze to stop bleeding usually can only have arterial bleeding requiring immediate ligation of bleeding.
3. Suture: the placenta after delivery, according to the following parts, the level of suture. First with 2 / o No. gut, from the notch tip on the vaginal mucous membrane o. 5cm start, intermittent or continuous suture organized under the vaginal mucosa and vaginal mucosa, issued hymen ring, ring hymen aligned margin of attention. Using the same gut interrupted or continuous suture levator ani muscle and subcutaneous tissue. Skin incision with a 1 under the specific circumstances of silk or 2 / o mushrooms Joe interrupted suture line, or 2 / 0 shield Joe intradermal suture line.
(B) median incision of the perineum
1. Cut: the left hand indicated that the two fingers into the vagina Chung, jump vaginal wall. Scissors with his right hand holding a joint along the middle vertical perineal incision length 2.5-3cm. Be careful not to damage the anal sphincter.
2. Suture: the "episiotomy technique." First suture the vaginal mucous membrane, subcutaneous tissue and then suturing perineal body, and finally suturing the skin incision. Questions?
Treatment after
1. Incision iodophor disinfection. Day 2. Give antibiotics to prevent infection.
3. Incision suture 4-5 stitches. If Joe suture with mushrooms, you do not need stitches.
When stitching? The fetus after birth, you can repair surgery.
In general, the second only needs mending laceration wounds, but to be judged as the physician, although sometimes only once laceration, but the doctor deems it necessary or will be mended.
How to do the toilet?
(1) If no serious laceration, mothers can be a normal toilet, but painful wounds a few days ago, to a little patience, and to pay attention to cleanliness, to prevent bacterial infection.
(2) If the tear has affected the level of the urethra (the wound up tearing), resulting in voiding the inconvenience, you may need catheterization.
When stitches?
Experts said the use of perineal surgical repair is the suture that can be absorbed by the body, so there is no so-called problem of stitches, in general, about a week or so the wound will heal, but the rate of suture is not absorbed by the body so fast.
How long will the wound recovery?
Generally not a serious wound about 3 - 4 days will not hurt, and adequate blood supply around the vagina, as long as there is bacterial infection, about a week or so to heal the wound.Experts point out that, regardless of whether the production perineal incision, the baby through the birth canal will be the same, as will not affect the postpartum urinary incontinence, in fact, and the maternal pelvis size, baby size, speed and other factors of labor.
If the length of the production process, the baby stay in a long time the birth canal, the vagina is a long time distraction, are more easily lead to the occurrence of postpartum urinary incontinence, and episiotomy or not this relationship is not absolute.
The impact of future pain during intercourse
Production will affect the gaping wound of pain during intercourse, because the scar after suturing the perineum compared with the soft, it is relatively hard fibrosis, sexual intercourse with each other are likely to cause pain involved.
If the episiotomy or tearing wounds more smooth, not healing after repair scars, there would be no problem; the other hand, if the wound mess, the doctor has not repaired the scars under each cross involved, it is very likely to occur pain during intercourse situation.
Wound on the production of a second child
Perineal good blood circulation, blood flow is sufficient, so the wound healing ability is good, and will not affect the production of a second child.1. More intake of high fiber foods to avoid constipation. If women postpartum constipation, too much force in the solution will easily lead to the wound when the re-tear.
2. Develop regular bowel habits.
3. Add more water, drink enough to 2000cc.
Self-care:
1. After using the toilet flush: Women produce finished, the bathroom should rinse the perineum, as generally clean with toilet paper, washing up to the front to back, to avoid bacterial infection.
2. To keep wound dry: toilet, bath, pat the perineum with tissue paper to keep the wound dry and clean.
3. Avoid hard: Do not force the solution will be to avoid sewing the wound and then split.
4. Do not put heavy objects: within 1 month after delivery, not lifting heavy objects, nor do any of the family and taxing exercise.
5. To avoid sex: 6 weeks postpartum, the incidence of sexual intercourse should be avoided.
6. Swelling and pain can be gifted Code: laceration and wounds more severe swelling and pain are, you can add iodine in the water bath, or heat lamp to speed up recovery speed. (Povidone iodine to sterilization, warm water and high temperature heat lamp Zeyi promote blood circulation)
Magic formula to avoid a small episiotomy
Cheng Qin, MD fire as long as the little control diet during pregnancy to prevent the fetus is too large, and develop the good habit of exercise, not only can make labor easier, can also be cut to reduce the probability of the perineum.
Recommendation:
1. Pregnancy 5 - 6 months to eat starchy foods, and increasing protein intake can reduce the rate of weight gain, to avoid the baby is too large.
2. More walking, stair climbing and practice Lamaze breathing, etc., can strengthen muscles, to help production.


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