Whether birth or cesarean section, childbirth is an important “passing through” process in a woman’s life. To endure pain, she has to face various risks. Here is to introduce a maternal supine hypotension syndrome that seriously threatens the life of cesarean section women and fetuses. Once the syndrome is not dealt with in time, the maternal woman will have severe hypoxia and acidosis due to insufficient blood supply to the placenta, thereby seriously threatening the life safety of the maternal and fetus. So, how to prevent the hypotensive syndrome of the lying-up woman during cesarean section?
Maternal supine position
Inducing factors of hypotension syndrome
Maternal supine hypotension syndrome is a syndrome in which the maternal dizziness, nausea, vomiting, rapid heartbeat, and varying degrees of blood pressure drop occur when the supine position is taken during cesarean section. This is because the accessory ligaments and abdominal muscles of the uterus will be in a relaxed state at this time, and the uterus loses its support and at the same time is compressed by the influence of gravity on the inferior vena cava and abdominal aorta, resulting in a sudden decrease in the return blood volume, so it is also called “inferior vena cava Oppression syndrome”. This syndrome occurs in cesarean section, mainly related to the following factors:
When the postpartum woman takes the supine position during cesarean section, the enlarged uterus in the third trimester will cause compression of the inferior vena cava and abdominal aorta, resulting in obstruction of pelvic and inferior vena cava return flow, and the blood reaching the heart is suddenly reduced. The amount of blood in the heart will also drop rapidly, and the blood pressure will also decrease, causing hypotension syndrome in the supine position.
Anesthesia If a woman undergoes combined lumbar and hard anesthesia during cesarean section, anesthesia will cause dilation of the blood vessels in the anesthesia area, affect the blood circulation, and weaken the ability to compensate for circulation. In addition, due to the combination of lumbar and hard anesthesia, the muscles are relaxed, and the abdominal muscles cannot support the uterus. The weight of the entire uterus will be completely compressed on the inferior vena cava, resulting in problems such as blood stasis at the distal end and a sudden drop in blood volume. It causes maternal blood pressure to drop and triggers maternal supine hypotension syndrome.
Diaphragm compression The maternal enlarged uterus will also compress the diaphragm, causing vagus nerve excitement, resulting in a slow heartbeat, dilated heart blood vessels, and a drop in blood pressure, which can lead to supine hypotension syndrome.
How to prevent maternal supine hypotension syndrome
After the woman has taken the number of decubitus supine positions during cesarean section, if she has a hypotensive syndrome in the supine position of the delivery woman, she will show symptoms of nausea, vomiting, dizziness, chest tightness, paleness, rapid heartbeat and shortness of breath. It will also affect the vascular perfusion of the uterus, kidneys and placenta, resulting in intrauterine hypoxia, placental abruption, fetal heart rate slowing or fast or irregular, so that the fetus appears distressed in the uterus. Children are at risk of severe suffocation and even life-threatening. The intraoperative methods for preventing maternal supine hypotension syndrome are as follows:
Choosing the right posture After entering the operating room, the medical staff should first carefully ask the medical history of the mother. If the mother has a pelvic stenosis that is not proportional to the pelvis, horizontal position, twins, buttocks, huge children, and the mother has a supine hypotension In the history of syndrome, etc., after the maternal anesthesia, tilt the operating table about 30 degrees to the left and fix the maternal with restraint straps to prevent the maternal from falling into the bed. At the same time, use a soft cushion to raise the right hip of the maternal Around 5 cm. After the fetus is delivered, the operating bed is returned and the cushion is taken out, so that the lying-in woman lies on his back until the operation is completed.
Minimize the impact of anesthesia. From maternal anesthesia to the delivery of the fetus, inject 600-1000 ml of Ringer’s solution to the mother to increase the maternal cardiac output, which can reduce and prevent the synthesis of maternal supine hypotension to a certain extent. Sign occurs.
Psychological nursing emotional tension may lead to maternal supine hypotension syndrome. Maternal women have varying degrees of nervousness, depression, and other negative emotions due to the history of previous episodes or due to fetal position, twins, huge children, or abnormal birth canal. Therefore, the nursing staff should ease the maternal uneasiness with kind attitude, patient encouragement and gentle nursing actions, so that the maternal have a sense of trust, security and self-confidence, so as to maintain a good attitude to accept the cesarean section of the medical staff operating. Maternal women should also have the relevant knowledge of anatomical cesarean delivery before birth, and be prepared to face the unexpected situation in the production, overcome the fear, and calmly face the cesarean section.
Respond to abnormalities in a timely manner. During the cesarean section, medical staff should pay attention to observe whether the maternal women have the symptoms of hypotension such as paleness and yawning. Once the above symptoms are found, the maternal mask should be given oxygen immediately, if necessary, intravenous injection 10 ~15 mg ephedrine, and quickly remove the fetus.
In addition, maternity births should choose regular hospitals. Regular hospitals have experience in responding to emergencies and scientific treatment procedures, which can prevent the hypotension syndrome of lying-in women in the supine position to the greatest extent, and provide greater protection for the life safety of women and fetuses.