Define the soft birth canal for normal delivery in Obstetrics and Gynecology (28)

Definition: The curved tube composed of the lower uterus, cervix, vagina and pelvic floor soft tissue is a soft birth canal. Formation of the lower uterus: It develops from the isthmus of the uterus when it is not pregnant, and is 1 cm long at this time. The upper end is the narrowest part of the cervix called the anatomical internal opening, and the lower end is the boundary between the endometrium and the endocervix, called the histological internal opening. Gradually stretched after pregnancy, the elongation is 7-10cm after delivery. During uterine contraction, due to the contraction of the muscle fibers of the uterine body, the upper muscular wall becomes thicker and the lower muscular wall becomes thinner, forming a ring bulge at the anatomical inner mouth, called the physiological contraction ring. Disappearance of the cervical canal and dilation of the uterine orifice: The disappearance of the cervical canal and the dilation of the uterine orifice occur gradually after delivery. The cervical canal is 2-3 cm long before delivery. After the delivery, due to the contraction and retraction of the uterus and the direct compression of the fetal presentation and the anterior amniotic sac, the cervix expands outwards and upwards to form a funnel shape, and the cervical canal gradually shortens and disappears with the uterine opening. The expansion. The fetal membranes ruptured during the near opening of the uterine orifice, and the fetal presentation directly compressed the cervix to significantly accelerate the dilation of the uterine orifice. In primiparous women, the cervical canal disappears and then the uterine orifice is dilated, and the two are performed simultaneously in the perinatal women. The vagina stretches well, the vaginal wall mucosa folds flat during delivery, and the vagina expands and widens, which does not affect delivery. The fetus exposed after rupture directly presses the pelvic floor, and the lower soft birth canal forms a forward and upward curved tube. The levator ani muscle stretches down and on both sides, and the muscle fibers are elongated bit by bit, causing the perineum to be 5 cm thick. It becomes 0.2-0.㎝ thin. Therefore, the perineum body is under great pressure and it is easy to cause laceration.

Irregular flow of people is most likely to lead to habitual abortion

 Abortion is a remedy after unwanted pregnancy, but it must not be used as a method of contraception. Because the harm of artificial abortion is great.   Painless abortion is easy to cause habitual abortion. Each miscarriage mostly occurs in the same pregnancy month, and its passing is the same as that of a general miscarriage. The causes of initial miscarriage are often corpus luteum function deficiency, hypothyroidism, and embryonic chromosomal abnormalities. The most common causes of late miscarriage are cervix laxity, uterine malformations, and uterine fibroids. After pregnancy, patients with lax internal cervix often in the second trimester, the fetus grows up, amniotic fluid increases, gravity is added to the uterine cavity, the fetal sac protrudes toward the internal cervix, and the cervix gradually shrinks and expands.   Most patients have no symptoms, premature rupture of membranes, and the fetus can be discharged with it. If the bleeding time is too long and there is tissue remaining in the uterine cavity, it may cause intrauterine infection. In severe cases, the infection can spread to the pelvis, abdominal cavity and even the whole body, complicated by pelvic inflammatory disease, peritonitis, sepsis and septic shock, etc., called abortion infection .   Clinically, three or more spontaneous abortions are called habitual abortions. Habitual abortion is very harmful to the body. In life, we must pay attention to the prevention of habitual abortion. How to prevent habitual abortion? The prevention methods are as follows:   1. Regular life: You should keep at least 8 hours of sleep a day or more, and develop the habit of regular bowel movements every day to ensure smooth bowel movements.  2. Pay attention to personal hygiene: Change clothes and bath frequently. Especially pay attention to menstrual hygiene to avoid any infection.   3. Choose the right diet: Food should be easy to digest. In particular, choose foods rich in various vitamins and traces of helplessness, and be cautious in taking cold-flavored foods.  4. Keep a happy mood:&nbsp. Be sure to keep a happy mood and avoid all kinds of stimulation. Use a variety of methods to eliminate tension, boredom, and fear in order to reconcile emotions.  5. Be cautious about sexual intercourse: Within three months of pregnancy, sexual intercourse should be avoided after seven months of pregnancy, and intercourse should be strictly prohibited during this period for habitual abortions.  6. ​​Regular prenatal check-ups: Regular prenatal check-ups should be started in the second trimester of pregnancy, so that doctors can find and deal with abnormal conditions in time, and can guide health care during pregnancy.

Will the perianal abscess cure spontaneously?

 Perianal abscess occurs mostly in young adults aged 20-40, and there are more men than women. Will perianal abscesses heal on their own without treatment? will not. In the past, this disease was mostly treated with incision and drainage, but most of them will form anal fistula, which can only be cured by a second operation. What is the surgical treatment of perianal abscess? Let’s explore it below.   &Nbsp. Surgical treatment of perianal abscess    Yaoshu anesthesia, a radial or arc incision is made at the place where the abscess fluctuates, and the abscess is fully drained or the index finger is used to explore the abscess and separate the space between the abscess. Then flush the abscess cavity with hydrogen peroxide and normal saline in turn. Trim the skin flaps to make the incision into a fusiform shape for smooth flow. Hold the ball-tip probe and insert it from the incision, and gently and carefully probe along the bottom of the abscess cavity. At the same time, the index finger of the other hand goes deep into the anus, and the pointer is combined with the pointer to find the internal opening. Pass into the rectum at the highest point of the thinnest point between the pointers, introduce the rubber band, gather the two ends of the rubber band, and ligate and fix it after being tight. Vaseline gauze is filled into the incision, externally compressed with a tower-shaped gauze, fixed with a T-band and the operation is finished.   Use antibiotics as appropriate to control infection after surgery, and use emollients to prevent constipation. Fumigation and washing with nitrate alum lotion after defecation, routine dressing. If the rubber band does not fall off within 7-10 days after surgery, tighten the rubber band about 1 cm to speed up the fall off. After the rubber band falls off, use Shengji Powder to change the dressing until healed.   Perianal abscess will not heal spontaneously if it is incurable, so patients should be treated with the above-mentioned treatment methods. Incision and thread-drawing is a traditional treatment for perianal abscess. It mainly uses the continuous tension of the rubber band to gradually expand the internal opening and drainage channel. Although the internal mouth continues to be infected, it can ensure smooth drainage, which will not lead to the spread of inflammation, and is conducive to the growth of granulation tissue from the base. 

How to treat habitual abortion correctly

  How to treat habitual miscarriage correctly? Many young people get pregnant unexpectedly without being prepared to be parents and have to miscarry artificially. However, some people who are ready to be parents will experience spontaneous miscarriage, and some even have more than 3 consecutive miscarriages. This is the disease, called habitual abortion, so how to treat habitual abortion correctly? Let’s take a look at it together.  1. Traditional Chinese medicine believes that this disease is mostly caused by insufficient kidney qi, which is caused by the insufficiency of Chong and Ren. It is advisable to invigorate the kidney and spleen, strengthen the qi and nourish blood before pregnancy. Zishen Yutai Pills nourishes the kidney and invigorates the spleen, nourishes the vital energy and nourishes the fetus, strengthens the body, prevents habitual abortion and threatened abortion. Stop taking during menstrual period, take 2 months as a course of treatment, and take 1-3 courses.  2. If the patient has lax internal cervix, it should be repaired before pregnancy.  3. Patients with uterine malformations should undergo corrective surgery before pregnancy and contraception for one year after surgery.  4. Patients with cervical insufficiency who are already pregnant should undergo transvaginal cervical cerclage at 14 to 18 weeks of pregnancy, and follow up regularly after the operation. If abnormalities are found, they should be admitted to the hospital in time. 5. Insufficient corpus luteum function, it is recommended to inject progesterone or HCG as soon as possible, take the medicine until 10 weeks of gestation or more than the number of weeks of miscarriage, and need to rest in bed, prohibit sex, supplement vitamin E and give psychological guidance to relieve excessive mental stress , Pressure, etc.   6. Before conception, both men and women should go to the hospital for careful examination, including genital examination and necessary laboratory tests. If possible, chromosome examination can be done.  7. Regular prenatal check-ups should be started in the second trimester. The doctor can detect and deal with abnormal situations in time, and guide health care during pregnancy.   8. Women should always pay attention to a reasonable diet, especially pregnant women should pay more attention to dietary choices, should properly supplement vitamins and various necessary trace elements, etc., eat more fruits and vegetables.   Warm reminder: There are many reasons for habitual miscarriage, and the treatment methods are different. It is recommended to go to a regular hospital for active symptomatic treatment. Habitual miscarriage can be cured.