EasticCurvical Insufficiency ICH Diagnosis and Treatment Center for Medicine Fetal
Cervical Script is a well-known surgical procedure conducted during pregnancy and, sometimes, outside of pregnancy. It includes the imposition of a seam around the cervix for its mechanical support and reducing the risk of late miscarriage or premature birth.
a condition in which the use of the server has sufficiently convincing proof - the so-called Eastic-cervical lack of disadvantage (ICN) at which either miscarriages in the period of 18-22 weeks without special fights, often repeated, or early premature genera with 22 weeks for the same scenario. ICN is less than 1% of pregnant women and 8% of the total habitual misunderstanding in the second trimester
when the seams are applied
- injury to the oral cavity;
- Difficult tooth removal;
- holding gingivotomy and gingivectomy;
- Correction of bridle lips or language;
- patchwork;
- excision of a hood over a retinated tooth;
- Removal of neoplasms and cyst.
types of seams
- nodal seam with stitching forms a number of single nodes. Incorrect overlaying one node will not affect the state of others. Suitable for any kind of surgical intervention.
- simple continuous seam is similar to a simple tailoring seam. Used for embedding long shallow wounds.
- Continuous verbal seam differs from the previous overlay of an additional loop for each stitch. It is used to flow wounds on the peele surface of the oral cavity.
- Mattress seam allows you to accurately combine the edges of the wound. Suitable for the closure of wounds over bone catering (alveoli tooth).
Tools and materials
- needle-holder (for fixing the needle);
- eye surgical tweezers (to hold the edges of the wound during stitching);
- Small double hook (helps to fix the edges of the wound, especially when the needle is moving from the inside out);
- Eye scissors (for trimming the thread).
Suture needles are made of stainless steel in a different format, which is determined by the diameter of the suture thread. A needle can be round (rarely) or triangular. It is a triangular version with a reverse cutting edge is considered the least traumatic to work with soft tissues of the oral cavity.
Eastic-cervical insufficiency (ICH) is a dangerous state that can lead to spontaneous interruption of pregnancy or premature birth. ICN is diagnosed in 15-42% of cases of non-obscuration and most often the diagnosis is made only after interrupting pregnancy.
What is Eviliko-cervical insufficiency
ICN is the inability of the cervix of the uterus remain in the closed state during pregnancy. In this case, there is a painless disclosure of the cervix, leading to a spontaneous interruption of pregnancy in terms of 14 weeks and more.
Types of Eastic Cervical Insufficiency
The risk group of the occurrence of ICN includes the presence of miscarriage and early spontaneous genera in the history of the patient; The injuries of the cervix resulting from the scraping of the uterine cavity, traumatic childbirth, radical surgical methods of treating erosion; Application of auxiliary reproductive technologies, hormonal disorders.
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Tonus of the uterus during pregnancy Hypertonus during pregnancy uterus in a tone during pregnancy Tone of the uterus in the second trimester, the causes of hypertonus, prevention, drug treatment during pregnancy. Victoria Gutsanian doctor Akusherginecologist, Moscow. Often, this symptom of the threat of pregnancy interruption remains unnoticed by the future mother, which leads to more serious consequences. You have ever been doing sports raised gravity. Squeeze your hand in a fist what is forces. Look at the muscles of the hands they have increased, they began to be clearly contoured, they seal came to the tone. Just as the activation of skeletal muscles occurs, they come into the tone and muscles of the uterine myometrium. With the only difference that the processes of the tension of the muscles of the hands, legs, the back are subject to your desires, since their work is controlled by the central nervous system. With the uterus, things are more difficult, nothing depends on your will. The uterus in the tone of the symptoms What kind of symptoms can tell us about the tone of the uterus, it is primarily pulling, monotonous, long-term pain at the bottom of the abdomen, without a clear localization. Somewhere below, as under menstruation, patients often say. The pain can be given to the area of the lower back, the sacrum, crotch. In the second and third trimesters, putting hands on the stomach, the future mother independently defines a dense uterus with clear contours. Often there may be blood discharge from sex tract. It is important to remember that any non-bright isolation beige, brown, pink, with streaks of blood, scarlet, abundant, separators are regarded as blood. They are dangerous during pregnancy and require immediate appeal to the doctor. Diagnostics Hypertonus uterus. Female, a hollow muscle organ located in the middle of a small pelvic cavity. Like any smooth muscle tissue, the myometrium has the properties of excitability, tone, stretching, plasticity and elasticity. Normally, during pregnancy, the uterus should be relaxed. It is in this case that favorable conditions are created to attach the fetal egg, the formation of the placenta. The uterus occurs and the development of the fetus occurs, the extraordinary structures of the placenta, the oily water, uteros, the shell are formed. For a number of reasons, the myometrium can come into the muscle tone thickened, becomes dense. During the inspection of a woman on a chair in the first trimester of pregnancy, the doctor an obsherginecologist very clearly defines the hands of an increased tone. The thickening of the wall of the uterus sees during the study and the doctor conducting ultrasound diagnostics. At the same time, in the conclusion, it usually refers to the problem of the following terms Tonus myometrium is elevated either hypertonus myometrium. The consequences of Hypertonus every future mother should understand that no matter how the tone is determined at the reception when examining the doctor with an obsteverginecologist, it is independently or during an ultrasound study, it is a threat of abortion. The tone of the uterus requires close attention of both women and a doctor leading pregnancy. The musometry tone in the first trimester leads to the detachment of the fetal egg, Chorion is so called the future placenta and, as the result, the spontaneous miscarriage happens. Often, the interruption of pregnancy does not occur, but the pregnancy is pregnant because of a large detachment area, stops in its development due to dysfunction and delivery of oxygen. At the same time, the woman does not bother blood discharge, only periodic pains at the bottom of the abdomen appear. And with a screening ultrasonic study in 1113 weeks, it turns out that the pregnancy is undeveloped, measuring on a period of 67 weeks, visualizes the large retrochemical hematoma. Blood accumulation during the detachment of the flicer egg from the chorion of the precursor of the placenta. In 2 and 3 trimester, the miometrium tone rarely leads to the placenta detachment, only in the case of its abnormal location, the low placentating or if the placenta overlaps the area of the internal zea. But there is another danger. The uterus squeezes the fetal bubble with the baby and the arrogant waters, which after 20 weeks there are already a lot of 6001500 ml at the diluted timing. Pressure pressure on the lower segment, internal zev. A fetal bubble under the action of a tone begins to work according to the type of wedge, the cervix opens and premature childbirth occur. It happens that the oily water is departed with the stored neck of the uterus. But the result is one interruption of pregnancy. The causes of hypertonus causes the appearance of the tone of the uterus during pregnancy many. It is rarely distinguished by some one, more often they combine stress, lack of sleep, heavy physical work, a number of work, sports, air travel, moving long distances, sex life up to 12 weeks of pregnancy, colds. An important role is played by bad habits smoking, alcoholism, but there are other factors leading to an increased tone of the uterus. Infections. First of all, these are infections transmitted by sexuality of chlamydia, mycoplasma, ureaplasma, viruses, etc. They cause inflammatory processes of small pelvis organs, including in the uterus. The synthesis of anti-inflammatory cytokines is intensified, these are biologically active substances that provide an inflammatory response in the body and adversely affect the course of pregnancy and the development of the fetus. These include interleukins, interferon, increasing the tone of myometrium. In addition, in this case, the probability and intrauterine infection of the kid is high. Hormonal disbalance. Insufficiency of progesterone is an equally rare cause of an increase in the tone of myometrium. Progesterone is especially important in the first trimester of pregnancy. It relaxes the myometrium, contributes to the normal processes of implantation and the formation of the placenta. In the first trimester, this hormone is synthesized by the yellow body of the ovary, with its insufficient progesterone function produces little, and pregnancy proceeds against the background of the uterus hypertonus, which leads to the threat of abortion. By 16 weeks, the synthesis of hormones take the placenta, and the risk of unbearab decreases. In addition to progesterone failure, there are a number of hormonal disorders, as a result of which the pregnancy proceeds with the threat of a hyperandrode interrupt increase in the level of men's genital hormones, hyperprolactinemium. Increased level of blood prolactin hormone, hyper or hypothyroidism, autoimmune thyroiditis. At-risk groups. After surgical interventions in the uterus, abortion, diagnostic manipulations, bodies complicated by the inflammatory process, can be formed by intrauterine syneficia. In such cases, pregnancy proceeds against the background of an increased tone of the uterus, with a threat of interrupt, with blood discharge. Endometriosis, myoma is especially the location of the tumor when it goes into the uterine cavity, deforming it, all this circumstances accompanying the increase in the tone of myometrium during pregnancy. In women with violations in the hemostasis system, the complex of the body's reactions aimed at preventing and stopping bleeding, with changes in the indicators of coagulation or anticular blood systems, the presence of antibodies to cell phospholipids The pregnancy proceeds with an increased tone of the uterus, starting from the smallest time. Multiple pregnancy, pregnancy, complicated by a multi-way, low, often passes against the background of the tone of the uterus and is complicated by premature childbirth. In patients with chronic diseases, with severe somatic pathology, for example, bronchial asthma, diabetes, having suffered colds, viral diseases during the current pregnancy, very often there is a tone of the uterus. How to treat Hypertonus uterus Tonus, of course, you need to shoot, the uterus must be relaxed, otherwise this state can end with spontaneous miscarriage. If the future mother is not included in any of the risk groups, she has everything in order with health, this is the first pregnancy that has come without any problems and flowing safely to the present moment, there were no blood discharge from the genital paths for all the time to wear, but at the same time a woman A minor pulling pain is bolted at the bottom of the abdomen and, according to the doctor, the tone of the uterus is elevated either the uterus of the excitment during palpation can be carried out an outpatient treatment, but with mandatory compliance with the beddown. Therefore, it is important to remember that any work, even a routine, at home and speech can not be given in this case, noszpa antispasmodics are appointed in tablets, candles with papaverine, vitamins, Magna B6, sedatives Valerian, mother-in-law, possibly the appointment of Duphaston gestage preparations, Uremines. Dosages and treatment diagrams are prescribed individually for each patient by a doctor. If the future mother of the house or at work felt the characteristic pulling pain at the bottom of the abdomen, and there is no possibility to contact the attending doctor, it is necessary to drink a nose in a dosage of 0.040.08 g, you can enter a rectally candle with papaverine and take 2 valerian tablets. If the future mother is included in the risk group, blood discharges appeared, grabs. Different pain at the bottom of the abdomen need immediate hospitalization in the hospital. The treatment conducted in the hospital will depend on the period of pregnancy and the clinical picture. In 1 trimester usually prescribed intramuscular injections of papaverine, nosheps, progesterone, vitamins, sedatives of sedatives, urozhastan or duphaston. These drugs have a different mechanism of action, but the result of their reception is one relaxation of the uterine muscles. In the case of blood discharge, it is necessary to appoint hemostatic hemostatic hemostatic drugs for sodium ethalate, ditinon, transkama. After 16 weeks, the arsenal of drugs to reduce the tone of the uterus expands, and, at the same time, there is no need to use hormonal drugs. These periods are usually started to gradually cancel, in the absence of testimony to a longer reception. Additionally, physiotherapeutic treatment can be appointed, contributing to the relaxation of the mother-in-law muscles. These methods include endonazal galvanization. Application with therapeutic purposes of continuous DC low force and low voltage, resulting in contact with the electrode. Magnesia electrophoresis Impact on the organism by direct current and administered with its help through the skin or mucous membranes by particles of the magnesia of sulfate magnesia. Electric analyzing anesthesia with weak electrical discharges served through the skin that block the conduct of pain pulses to the brain. Uterine Electroscience Impact on the nervous uterine apparatus by variable sinusoidal current to suppress the contractile activity of this organ. In the threat of pregnancy interrupts from 1516 weeks, the electric relocation is a more preferable method in front of other methods of therapy of the threat of interrupt, since there is no side effect of medicines, and the effect occurs during the procedure. Uterine electrodelucciation can be used to provide emergency assistance in the threat of pregnancy interrupt. In 2 and 3 trimester, an intravenous drip administration of Ginipral, Magnesia sulfate, possibly. Also the injection of spasmodics papaverine, noszpa are also shown. Preparations of calcium channels of Nifedipine calcium channels are recommended, Corinthar. These drugs block calcium channels in myiometry, calcium is not transported, the muscle cannot be reduced and relaxes. To enhance the antispasmodic effect, we add tableted forms of drugs that reduce the tone of the uterine ginipral, nospa in tablets, as well as candles with papaverine. Mandatory in the treatment regimen include vitamins in injection form intravenously, in a tablet form in order to improve metabolic processes, the normalization of the CNS activities. Sedative preparations are prescribed in tablet form or in the form of tinctures. It is necessary to use funds that improve the mint-plated circulatory circulation, pentoxifyllin, eufillin, trental, drugs that improve the exchange processes of actovegin, kocarboxylase, riboxin, potassium orotat, pantothenate calcium, lipoic acid, antihypoxants drugs that increase the stability of fetal nerve cells to the lack of oxygen instenon, piracetam, Hepatoprotectors of substances that improve the function of the liver of hofitol, essential. Increased tone of the muscles of the uterus is a reason not for emotions, but for a more careful attitude towards yourself. Therefore, if the doctor put a future mother diagnosis of Hyperthonus of the uterus, she needs not to be upset, and the challenge would pay a little more attention to his state and listen to the advice of the attending physician.
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