Some concepts on IUD after placing: Dr. Anutosh Chakraborty
The IUD is a contraceptive device placed in the uterine cavity.
There are currently two types:
- Unmedicated
- Medicated
The former is made of stainless steel, plastic, or silica gel, and the latter is made of copper, zinc, or progesterone. Active substance. The main function of the intrauterine device is to prevent the fertilized egg from implanting, while the medicated device retains anti-pregnancy drugs to enhance the contraceptive effect. Both types of IUDs act quickly after being placed, and the effect disappears after being taken out. Therefore, it is safe, effective, simple, and does not affect fertility after removing the device...
Preventive health care measures
i) After the IUD is placed, there may be slight pain in the lower abdomen due to uterine contractions, and it is generally not necessary to take analgesics. Avoid using uterine contractions such as mother ointment.
ii) Rest for 2 days after putting on the IUD, and do not do heavy physical labor within 2 weeks, especially labor and exercise that increase abdominal pressure.
iii) There may be a small amount of vaginal bleeding after the IUD is put on, and there is no need to be nervous. Generally, the bleeding stops automatically after 2 to 3 days. If there is continuous bleeding or the amount of menstruation, you should go to the hospital in time.
iv) Bathing and sex should be forbidden within 2 weeks after surgery to avoid infection.
Experts reminded that the ring should be reviewed regularly after placing the ring. Generally, it is required to check once a month, 3 months, half a year, and 1 year after the ring is released, and then once a year until it is taken out. This is because irregular bleeding or falling off after the ring is placed mostly occurs within half a year or one year after the ring is placed. Regular inspection helps to find the problem in time and deal with it in time.
The placement time of the contraceptive ring varies according to the type. During the operation, the doctor will inform the type and effective time of the ring, which should be remembered and reviewed on time.
The umbilical cord, baby's lifeline
The umbilical cord is the bond between the mother and the fetus. Through this thin belt that connects the placenta and the fetus, there is a frequent exchange of substances between the mother and the fetus. The mother continuously transmits nutrients and oxygen to the baby, and the baby transfers waste products. Send it to the mother, and the cycle continues until the fetus is born. Once this busy transportation hub is blocked or interrupted for some reason, it will have a serious or even fatal impact on the fetus.
There are many possible problems with the umbilical cord. Among them, the most prone to occur and the most troublesome for expectant mothers is the umbilical cord around the neck. With the development and widespread application of ultrasound technology, it is not difficult to find the umbilical cord around the neck. Once the mother-to-be knows, it is inevitable to panic for fear of the baby's danger. It is difficult to generalize whether such panic is necessary.
First of all, let's look at the probability of the occurrence of an umbilical cord around the neck. According to statistics, about 20-25% of fetuses have an umbilical cord around their neck. Among them, there are only a few cases of fetal hypoxia or death due to the umbilical cord around the neck. In other words, although a quarter of babies are bypassed by the umbilical cord, most of them are born safely. This shows that excessive worry is unnecessary.
So, why does it happen that the umbilical cord wraps around the neck, and under those circumstances is it dangerous? Let us imagine it. In the second trimester, the baby floats comfortably in the warm amniotic fluid in the mother’s womb, and the umbilical cord also floats. When the baby develops to a certain level, he will move in the amniotic fluid, stretch out his hands and feet or even turn his head, most of the time he and the umbilical cord can live in peace, but he will entangle his hands, feet or body with the umbilical cord if he is not careful. When the space is large enough, he can turn over and go around again, so sometimes the umbilical cord can be seen around the neck during ultrasound examination but not around the next time. As the baby grows and grows bigger, the amniotic fluid swimming pool becomes relatively smaller for him, and he can no longer exercise significantly. At this time, if there is an umbilical cord around the neck, it will not be so easy to get out. Fortunately, the umbilical cord has a certain length. Most of the time, the umbilical cord wrapped around the baby's neck is like a scarf loosely wrapped around it. In this case, the umbilical cord and the baby's neck are not compressed and there is no danger. If the umbilical cord is not long enough or a naughty baby wraps it around the neck several times, the umbilical cord will tighten and affect the baby's blood supply. At this time, the danger will come quietly. Due to the compression of the umbilical cord, the supply of nutrients and oxygen is reduced, and the supply for the baby's growth is lacking, and fetal growth retardation and even fetal distress will occur.
Another danger occurs during childbirth. When the fetus is under the pressure of uterine contraction during natural delivery, the fetus will descend along the birth canal through the enlarged cervix. As the position of the fetus gradually drops, the umbilical cord is gradually tightened, which is normal. Under the circumstances, the umbilical cord is long enough to allow the fetus to be delivered safely. If the umbilical cord wraps around the neck, the length will be relatively reduced, which may cause the fetus to become hypoxic if it becomes too tight.
At this time, someone will ask: "How can we know if the baby is in danger?" During pregnancy, we can use ultrasound to understand the growth of the fetus. When the growth rate of the baby with the umbilical cord around the neck slows down or even stops, it will cause a high degree of vigilance. . Fetal heart rate monitoring is also one of the methods to assess the condition of the fetus. If the fetal heart rate monitoring is abnormal, it is necessary to suspect whether the baby is hypoxic. Especially in the process of natural delivery, fetal heart rate monitoring is especially important. For expectant mothers, counting fetal movements is the best method of self-monitoring. Many expectant mothers are not serious about counting fetal movements. In fact, this is very irresponsible. Every baby has its own activity pattern, which can only be mastered by the mother through careful daily experience. When the fetus is hypoxic, the fetal movement will change. It can be too frequent or it can be significantly reduced. When the fetal movement is significantly reduced or even disappeared, the baby will be very It's dangerous. But at this time, the fetal heart rate can still be maintained at a normal level for a period of time. At this time, the operation still has a chance to save the baby. If the opportunity is missed and the baby is hypoxic for too long, it will cause irreversible damage to the baby’s brain and other organs. Damage.
So is a cesarean section necessary for the umbilical cord around the neck? The answer is not the only one. We have already known that not all umbilical cords around the neck will have adverse effects on the baby. As long as the fetus's growth and development, fetal movement, and fetal heart rate monitoring are normal, it is completely possible to give birth naturally. Of course, if the umbilical cord wraps around the neck many times or when the fetus is suspected of hypoxia, it is wise and safe to choose a cesarean section.
There is also an abnormal condition of the umbilical cord that is very critical, that is, umbilical cord prolapse. We know that the normal fetal position is the head position, that is, the fetus is head down. When the fetal position is not correct or the fetus is too small, the umbilical cord easily slips from the gap to the under the exposed part of the fetus. At this time, once the membranes are prematurely ruptured, the umbilical cord will slip off first. If there is a contraction, the umbilical cord will be strongly compressed, which will reduce or even interrupt the blood supply of the fetus, causing the fetus to severely suffocate or even die in a short period of time. Therefore, once the umbilical cord prolapse is found, it is necessary for obstetricians to race against time to give first aid and strive to deliver the fetus by cesarean section in the shortest time. Take a thrilling rescue in the delivery room not long ago as an example. At noon that day, a woman who had just been admitted to the hospital for 35 weeks of pregnancy had a premature rupture of the membranes. The nurse listened to the fetal heart rate according to the routine and found that the fetal heart rate had slowed down. He immediately called the doctor. The diagnosis of umbilical cord prolapse was like a battle horn, and the delivery room was immediately mobilized. The doctor performing the vaginal examination is responsible for putting the fetal head in the vagina with his hand, trying his best to leave a line of space for the umbilical cord to prevent excessive compression. Some talk to their family members to explain the situation, and some keep monitoring the changes in the fetal heart rate with the fetal heart rate device. A few minutes later, an emergency operation was launched on the spot, and other anesthesia methods were too late, so I had to perform it immediately under local anesthesia. After three minutes of the operation, the baby was successfully taken out. After the first aid treatment by the pediatrician, the first cry was finally made. , All talents will put their hanging hearts back to their original positions. It can be seen that only early detection and early treatment of umbilical cord prolapse can strive for vitality.
For expectant mothers with breech position or other fetal position errors, they must have the basic knowledge to prevent umbilical cord prolapse. Generally, doctors will require these expectant mothers to be hospitalized in advance for delivery. This is to prevent various accidents, including umbilical cord prolapse. At this time, follow the doctor’s advice and do not do things on your own. If you find that your fetal membranes are broken when you are at home, don’t panic. You should lie down immediately, raise your buttocks, and then call an ambulance to the hospital in a lying position. In this way, even if the umbilical cord is below the fetal presentation, it will not be oppressed, and the baby's lifeline will not be threatened.
Post a Comment