Steps to perform artificial vegetable peel and control the uterus after childbirth

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The article was professionally consulted by Specialist Doctor II Bui Minh Phuc - Department of Obstetrics and Gynecology - Vinmec Ha Long International Hospital. Doctor has more than 18 years working in the field of obstetrics and gynecology.

1. Peeling artificial vegetables

1.1 What is artificial vegetable peeling? Artificial placental abruption is a procedure in which a hand is inserted into the uterus to remove the placenta after the baby is born. The purpose of artificial placental abruption is to actively remove the placenta from the uterine cavity to clean the uterine cavity, help the uterus contract better, or prepare to perform a test of the integrity of the uterus in the field. emergency case.
1.2 Indications Artificial peeling is performed in the following cases:
The placenta does not fall off naturally after the physiological rest period expires; Postpartum haemorrhage and unscarred vegetables; Postpartum haemorrhage and suspected residual placenta.

1.3 Implementation steps Before performing the procedure of artificial placenta removal, it is necessary to briefly explain to the mother and family for understanding, peace of mind and cooperation. At the same time, prepare sterile gloves, gloves, pain relievers, heart resuscitation drugs that can be used when needed, and an antiseptic betadine solution.
Techniques of artificial placental removal include:
One hand is placed on the abdominal wall to fix the fundus of the uterus; With the other hand put into the vagina and follow the umbilical cord, put your hand into the uterine cavity and find the area of ​​the placenta. Remove the placenta by using the anterior edge of the hand to squeeze between the placenta and the uterine wall. Peel from the edge of the bun from the center to the edge of the bun to avoid any omissions; When the placenta is completely peeled off, the inner hand of the uterus pushes the placenta out, without pulling out the hand, if necessary, the outer hand pulls on the umbilical cord to remove the placenta from the uterine cavity; During the procedure, if the uterus is contracted so that the hand cannot enter the uterine cavity, it is necessary to wait a little and then gradually dilate it manually, and at the same time, use drugs to reduce uterine contractility. If the placenta cannot be peeled off tightly in the case of the placenta, you should not try to peel it because it will damage the uterine muscle and bleed a lot. In this case, a hysterectomy is required. After removing the artificial vegetable, the uterus must be controlled immediately.

2. Uterine Control

Uterine control is a procedure performed after the placenta has come out. Aim to check whether the placenta is left or the membrane is left, and at the same time to check the integrity of the uterus.
Uterine control is indicated in the following cases:
Bleeding after placental abruption; Check the integrity of vegetables; Check the integrity of the uterus after difficult procedures such as forceps, abortion, intrauterine rotation, ... or on the uterus has had old caesarean scar. Steps to proceed:
One hand is placed on the abdominal wall to fix the fundus of the uterus, the other hand is inserted into the vagina, through the cervix into the uterine cavity to the bottom of the uterus, then check the fundus, the face in turn. anterior, posterior, two sides and two horns of the uterus with the tips of the fingers. If the uterus is contracting well, squeeze the hand inside the uterus, then gently pull out the hand If the uterus is flabby, not tight on the inner hand, it is a case of uterine atony. The following measures should be taken to help the uterus contract, perform until the uterus is tight, then withdraw the hand to avoid putting the hand in and out many times because it is easy to cause infection and shock due to pain.: Hand the inside of the uterus closes, gently pushing the fundus up; The outside hand massages the uterus into the uterus through the abdominal wall; Intrauterine inotropic injection: uterine contractions include oxytocin 5 units x 2 syringes into the uterine muscle through the abdominal wall, either intramuscularly or intravenously, and/or ergometrin 0.2 mg, intramuscularly. Or misoprostol 200 mcg, 2 tablets sublingually or rectally 3-4 tablets.

After artificial vegetable removal and uterine control, pregnant women need to inject or take antibiotics to prevent infection. Pregnant women after peeling artificial vegetables should pay attention to signs of infection such as fever, lower abdominal pain, vaginal odor, bleeding, ... so that they can be detected early and intervened in time.
In order for the whole process of pregnancy and birth to be convenient and safe, and for the baby and mother to be well taken care of after giving birth, you should register for maternity packages at reputable hospitals. At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of highly qualified doctors; Regular examination, early detection of abnormal problems; Maternity package to facilitate the birthing process; Newborns receive comprehensive care.

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