MBT outlet,Cesarean section analysis of the causes

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Analysis of the causes of cesarean section child choking

[Key words] cesarean section child; asphyxia; Analysis
Celiotomy Wean Asphyxia of Cause Analyse
Key words: Celiotomy Wean; Asphyxia; Cause
The past 10 years, due to the continuous improvement of perinatal technology and the popularity of monitoring methods, to early detection of fetal safety of the children get a lot of dignity that rescue,[link widoczny dla zalogowanych], which is the increase in cesarean section rate in recent years, one of the reasons However, indications of cesarean section on how to master the timing is critical, the paper far as our department from January 1985 to January 2003 cesarean section child suffocation and death were analyzed.
1 clinical data
1.1 General information from January 1985 to January 2003 in our hospital delivery of newborns to 5 040 cases in which vaginal delivery 3 168 cases of cesarean section for the 1 872 cases. Early neonatal asphyxia (children vaginal delivery and cesarean section) 300 cases,[link widoczny dla zalogowanych], accounting for the same period to 6.0% of newborns born by vaginal delivery in 230 cases of asphyxia, accounting for 7.3% of vaginal deliveries, cesarean section 70 cases of choking children, accounting for the same period profile Palace production 3.7%.
1.2 suffocation cesarean section indications of cesarean section in 70 cases, 48 cases of children in high-risk pregnancies, 22 were non-risk pregnancy. 27 cases of prolonged pregnancy, of which 7 were admitted to hospital the same day that the fetal heart rate ≤ 120 times / min, after oxygen, left lateral position, 25% glucose intravenous injection of 40 ml + dexamethasone 10 mg, did not improve; 2 cases low-set anterior placenta uterine B-misdiagnosed, due to cephalopelvic disproportion cesarean section. Lower segment uterine incision surgery see placenta pulls out, the baby is delivered was asphyxia. 1 case of encephalopathy caused by hypoxia, as low intellectual children, 1 case of intracranial hemorrhage cured after treatment; 2 patients posterior position, the whole cervix has reached 2 h, fetal aspiration line failure, fetal heart rate of 100 beats / min ~ 120 times / min, cesarean section showed a severe neonatal asphyxia out, after intubation, such as multi died; severe pregnancy-induced hypertension in 5 cases, 2 cases in which seizure control after 6 h (35 + Pregnancy 5 weeks to 36 +3 weeks). Emergency cesarean section; premature rupture of membranes in 12 cases, of which 5 patients were admitted to hospital uterine rupture of membranes 24 h and with no grass green amniotic fluid, and 3 cases of rupture of membranes 72 h, the sheep Ⅲ degree of water pollution. 4 cases of rupture after the intravenous use of oxytocin in labor fetal heart rate abnormalities appeared, and underwent emergency cesarean section.
1.3 Epidural anesthesia in 52 cases, local anesthesia and intravenous anesthesia in 18 cases. Pregnant women appeared flustered after epidural anesthesia, dizziness,[link widoczny dla zalogowanych], low blood pressure a total of 19 cases,[link widoczny dla zalogowanych], of which 6 cases of neonatal asphyxia after birth, local anesthesia and intravenous anesthesia in 8 cases because of fetal delivery in the 30 s before the intravenous infusion of ketamine injection, newborn child after birth asphyxia was purple, not the line about 3 min after the disposal of their own ease.
1.4 abdominal incision is too small, especially abdominal transverse incision is too small, children with high floating head, assistant abdominal pressure shall not be treated, a total of 11 cases. Of which 4 cases of extraperitoneal cesarean section, 3 cases of abdominal transverse incision is too small, 4 cases because of the high floating fetal head, take the first difficult, 2 cases with fetal head high floating anterior placenta, so that smaller incision, taking head for too long, causing intrauterine premature breathing.
1.5 Characteristics of amniotic fluid in 70 cases of meconium in 35 cases, 9 cases in which polluted Ⅲ, Ⅱ degree of contamination in 14 cases, Ⅰ degree of contamination in 12 cases, 45 cases of normal amniotic fluid.
1.6 cause of death in 2 cases of neonatal asphyxia neonatal deaths are to do an autopsy, were intracranial hemorrhage (ICH), aspiration pneumonia.
1.7 2 cases of neonatal asphyxia part of the lower wisdom tracking children, 2 cases of epilepsy hypoxic ischemic encephalopathy.
1.8 neonatal Apgar score of 0 points 2 patients died ~ 1; 2 cases of 2 minutes, and the remaining sequels; 3 to 4 minutes and 35 cases; 5 to 7 points in 12 cases; ≥ 7 points in 19 cases.
2 discussions
Recent years, statistics show that the main reason of early neonatal deaths hypoxic ischemic disease (HIE). HIE and perinatal hypoxia are the basic conditions and ICH occurred in the root cause [1]. Beijing Maternity Hospital reported [2], who had intrauterine hypoxia, cesarean section and vaginal delivery HIE and the incidence of ICH is basically the same. Children in this group of asphyxia cases of cesarean section are many reasons, which accounted for 48 cases of high risk pregnancy, accounting for 68.6%, incidence 2.56%, mainly due to asphyxia, intracranial hemorrhage top the list, followed by neonatal aspiration pneumonia, lung atelectasis, consistent with this view,[link widoczny dla zalogowanych], so to prevent pregnancy, birth, fetal, neonatal hypoxia is critical, this should be noted that the following aspects.