Adhesion will blur the anatomical level and complicate the cesarean section approach; The heavier the adhesion, the higher the risk of bleeding and peripheral organ damage during adhesion separation. Pelvic abscess and endometriosis are easy to form adhesions, even "frozen pelvis" (referring to the female pelvic wall, fallopian tube, ovary and uterus being fixed by blows, and the patient's entire pelvic cavity is hard and lumpy, just like being frozen). Chen Jing, director of obstetrics, informed the patients in detail about the illness and risks at the early stage of perinatal care, and made careful perinatal management measures and delivery plans, and analyzed the possible situations and countermeasures in detail before operation.
With the sound of anesthesia monitor, cesarean section began. As expected, Xiaolan's abdominal wall is closely adhered to each layer, and a wide range of adhesion zones can be seen between the omentum and the uterine bottom, the lateral peritoneum and the uterine side wall, and the bladder and the anterior wall of the uterus. In the past, a large number of wrapped adhesions were seen around the surgical site of uterus, and the normal position structure of uterus and accessories disappeared. This means that the biggest risk of this operation is that bladder and intestinal appendages may be damaged during the operation; And the peeling surface may bleed.
The department arranged an experienced deputy director obstetrician and chief physician Li for the operation. After patient and meticulous adhesion and separation, the bladder and omentum adhered to the front of the uterus were separated one by one to expose the uterus. The breech newborn was successfully delivered, and then the wrapped adhesion beside the uterus and the adhesion of the posterior wall of the uterus were relieved. The next most important thing is to suture to stop bleeding. The neovascularization in the extensive adhesion area forms the basis of bleeding and exudation. From the judgment of bleeding position to the choice of needle and thread model, from the consideration of needle entry position to the judgment of needle exit distance, and Dr. Li are calm and calm, and every suture is meticulous and step by step. With the passage of time, the hemostasis was gradually completed and the operation was coming to an end.
At this point, this woman with congenital genital malformation has undergone three corrective operations since childhood, and it took six years of hard pregnancy to finally become a great mother!
At the beginning of the Year of the Tiger, the obstetrics department of our hospital had such a difficult cesarean section, which was a good start. Of course, we have completed such a difficult operation many times, which depends on the usual surgical skill training of the department, the rich surgical experience of the surgeon, the strict requirements of the doctor for each operation, and their wisdom and kindness.
Different cesarean sections are only for the same joy, that is, the safety of mother and baby. "Obstetricians" will, as always, protect the health of mothers and babies with superb medical skills and dedication and courage to take on medical ethics.
skill
Pregnant mothers who have a history of previous operations, especially pelvic and abdominal operations, must make as many copies of the surgical records as possible and provide them to perinatal health care doctors truthfully, which is of great significance for evaluating perinatal risks and making diagnosis and treatment plans.
Authors: Obstetrics