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Analysis of cesarean section incision line abortion perforation in 1 case

Author: JiaGuoXian,WuRiNa From: www.yourpaper.net Posted: 2010-06-24 13:31:03 Read:
[1] uterine perforation; abortion; degree of flexion; uterine size; cesarean section; conservative treatment
Abortion is not a major family planning measures, but it is the main remedy after contraceptive failure, so abortion is always the largest number of birth control surgery a surgery. Uterine perforation is one of the common complications of abortion, such as failure to timely diagnosis and improper handling can endanger the patient's life. Now a uterine perforation analysis reported below.
A case report
Pregnant women, 30 years of age, pregnant 4 production on May 20, 1997 due to the cesarean section six months, stopped after 50 days, early response, make their own positive urine pregnancy test. B-ultrasound: bladder filling, anteversion position, size 9.2cm x 6.4cm x 5.6cm, seen in its 2.3cm x 2.0cm dark echo area, dual attachment is no exception. Tip: early pregnancy in the uterus. Normal blood. Emptying the bladder, the flow of people is routine disinfection, after by number dilatation, with a 6-pipette Palace 2, negative pressure 500mmHg, patients perceived pain, exit straw, the cervix is ??visible with yellow the omentum-like things immediately stop the operation, cervical injection of oxytocin 10U, normal blood pressure, the higher-level medical units under local anesthesia, laparotomy, see the left top of the cesarean section omentum from the penetration of the uterus, ligation of the greater omentum resection, cervix remove large omentum 9cm, consider the flow of people scrape, suture perforation, abdominal no bleeding, the abdomen was closed. Patients given antibiotics and oxytocin was discharged five days.
2 Discussion
2.1 uterine perforation risk factors for breast-feeding, long-term oral contraceptives, uterine malformations, uterine scar. To identify the direction of the uterus and uterine cavity length of not overcorrection flexor pour the uterus, in violation of the routine operation, plus curettage can not operate under direct vision, and could easily lead to uterine perforation.
2.2 preventive measures for the prevention of uterine perforation, we must first vigorously promote the family planning do propaganda and contraception. Strengthen the grass-roots health personnel training. So that each time before surgery to learn more about history, accurate estimates of the size and position of the uterus and pregnancy month within the patient. Conditionally to do B-positioning gestational sac size, the size of the uterus. Anteversion bit stretch the posterior lip of the cervix, to alleviate the uterus and cervical curvature to reduce uterine perforation. The opposite uterine bit operating. The Palace Koujin or cervical bad development in the preoperative preparation of cervical dilatation. There are three ways: (1) paracervical injection of 1% lidocaine 2ml, intrauterine injection of 1% lidocaine 5ml, 3min after surgery [1]. (2) mifepristone 25mg 3, 1 day prior to oral administration of [1]. (3) prior to surgery misoprostol 200g, 1 ~ 2h put next to the cervix. Equipment into the uterine cavity, each number dilatation, and the forward direction of the longitudinal axis of the uterus, action should be gentle, do not use violence, we should not be too hasty.
2.3 uterine perforation treatment of uterine perforation for family planning is one of the most serious complications of surgical abortion, but a low incidence. Caused by a variety of surgical instruments, the probe, cervical dilators, straws, curette and placenta clamp. When the equipment into the uterine cavity exploration than the palace at the end, suggesting that the perforation of the uterus. Such as straw or placental clamp perforation, sometimes the intra-abdominal tissue sucked out or clamp. Pregnancy was cleared perforation, no significant complications, should immediately stop operation, and to give the injection uterotonic, close observation of the use of antibiotics to prevent infection, hospitalization, intrauterine pregnancy residue should correct the position of the uterus, the cervix tight best to take cervical softening method by experienced physicians to avoid the perforation site to complete the surgery or laparoscopic help tocolytic agents can also be applied to 10 days after re-abortion.
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