Table of contents (expand)
- Anatomy of the female genital organs
- Anatomy of the female genital organs (continued)
- Physiology of the female reproductive system
- Anatomy of the female pelvis
- Fertilization and development of the fetal egg
- Changes in a woman's body during pregnancy
- Diagnosis of pregnancy
- Signs of fetal maturity, the size of the head and body of a mature fetus
- Examination of a woman in labor
- Physical examination
- Physical examination (continued)
- Physiological childbirth
- Biomechanism of labor in anterior occiput presentation. Seven basic fetal movements during labor
- Pain relief during labor
- Management of the second stage of labor
- Management of the third stage of labor
- Childbirth with breech presentation of the fetus
- Childbirth with extensor presentation of the fetal head
- Transverse and oblique position of the fetus
- obstetric turn
- Childbirth with prolapse of small parts of the fetus, large fetus, fetal hydrocephalus
- Anomalies of labor activity (pathological preliminary period, weakness of labor activity)
- Anomalies of labor activity (violent labor activity, uterine tetanus)
- placenta previa
- Premature detachment of a normally located placenta
- Diagnosis, delivery in case of premature detachment of the placenta
- Birth injury
- Clinic, diagnosis, treatment for birth trauma
- Toxicosis of pregnant women
- Toxicosis of pregnant women (continued)
- Late toxicosis of pregnant women
- Clinical picture of OPG (dropsy, nephropathy)
- Clinical picture of OPG (preeclampsia, eclampsia)
- Treatment of preeclampsia
- Premature termination of pregnancy
- Bleeding in the early postpartum period
- Treatment for bleeding
- Infusion-transfusion therapy of acute massive blood loss in obstetrics and gynecology
- Hypocoagulation phase of DIC syndrome
- Modern technologies for providing emergency infusion-transfusion care in acute massive blood loss
- Ectopic pregnancy
- Diagnosis of ectopic pregnancy
- Inflammatory diseases of the female genital organs (bacterial vaginosis, chlamydial infection)
- Inflammatory diseases of the female genital organs (viral infections, candidal colpitis)
- specific infections. Gonorrhea
- Trichomoniasis and tuberculosis of the genital organs
- Endometritis
- Postpartum endometritis
- Pelvioperitonitis and parametritis
- Menstrual irregularities
- Diagnosis and treatment of menstrual irregularities
- Endometriosis
- Hysteromyoma
- Diagnosis and treatment of uterine fibroids
- Pregnancy is multiple
- Intrauterine fetal death. Fruit-destroying operations
56. Intrauterine fetal death. Fruit-destroying operations
Fetal death during pregnancy refers to antenatal mortality, death during childbirth - intrapartum death. The causes of antenatal death of the fetus can be infectious diseases of the pregnant woman, extragenital diseases, inflammatory processes in the genitals. The cause of fetal death can be severe OPG-preeclampsia, pathology of the placenta and umbilical cord, entanglement of the umbilical cord around the neck of the fetus, oligohydramnios, multiple pregnancy, Rh incompatibility of the blood of the mother and fetus. Fetal death in the intranatal period, in addition to the above reasons, may be associated with traumatic brain injury and damage to the fetal spine during childbirth. The immediate cause of fetal death is intrauterine infection, acute and chronic hypoxia, fetal malformations incompatible with life. Clinical manifestations of antenatal death of the fetus are the cessation of growth of the uterus, the disappearance of engorgement of the mammary glands. A woman complains of malaise, weakness, a feeling of heaviness in the abdomen, and the absence of fetal movements. During the examination, there is a decrease in the tone of the uterus and the absence of its contractions, palpitations and fetal movements. A sign of intranatal fetal death is the cessation of his heartbeat. If antenatal fetal death is suspected, the pregnant woman is urgently hospitalized for examination. Reliably the diagnosis of fetal death is confirmed by the results of FCG and ECG of the fetus, which register the absence of cardiac complexes, and ultrasound.
Ultrasound in the early stages after the death of the fetus determines the absence of his respiratory activity and heartbeat, fuzzy contours of his body, in the later stages, the destruction of body structures is determined. In case of antenatal fetal death in the first trimester of pregnancy, the fetal egg is removed by scraping the uterine cavity. With the death of the fetus in the II trimester of pregnancy and with premature detachment of the placenta, urgent delivery is required.
In this case, the method of delivery is determined by the degree of readiness of the birth canal. In the absence of indications for urgent delivery, a clinical examination of the pregnant woman is carried out with a mandatory study of the blood coagulation system, then labor induction is started, creating an estrogen-glucose-vitamin-calcium background for 3 days, after which the administration of oxytocin, prostaglandins is prescribed. In order to accelerate the first stage of labor, an amniotomy is performed.
With antenatal death of the fetus in the third trimester of pregnancy, childbirth, as a rule, begins on its own. In case of intranatal fetal death, according to indications, fruit-destroying operations are performed.
Author: Ivanov A.I.
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