How to have a good baby

Author: Editor-in-Chief: Hu Xiujin
Publisher:
Publish Date: 1999-10-01
Features: Fragments: Two types. Symmetrical types are divided into two: one has a uniform appearance and maintains the original shape of one uterus but has two uterine cavities, completely or incompletely separated by a septum; the other has an appearance of two uteri but is essentially two half-uteri, resembling a heart-shaped uterus, bicornuate uterus, or didelphic uterus. Asymmetrical types of double uterus may have one side as a rudimentary horn of the uterus. The impact of uterine malformations on pregnancy varies depending on the type of malformation. Some uterine malformations do not affect fertility and do not cause any complications during delivery. However, most are due to uterine underdevelopment and a narrow uterine cavity, leading to smaller fetal size, or restricted fetal movement, making it easier to develop malpresentation, or poor uterine muscle contraction after delivery, resulting in increased postpartum bleeding and postpartum hemorrhage. Some women with malformed uteri can become pregnant but are prone to repeated miscarriages or preterm labor, or intrauterine fetal death. Underdeveloped uteri, during pregnancy, due to poor uterine muscle development, cannot grow with increasing gestational age, making it easier to occur uterine rupture, which can be life-threatening (see Figure 2). (3) Benign vaginal tumors include vaginal cysts and solid tumors, with varying sizes. They often cause no obvious discomfort and are difficult to detect without gynecological examinations. However, larger tumors may affect fetal body and head descent during pregnancy and delivery, obstructing delivery. Therefore, gynecological examinations should be conducted before pregnancy to detect and surgically remove them early. (4) Uterine fibroids are benign tumors of the uterine muscle layer, also known as leiomyomas, and are the most common pelvic tumors in women. They are prone to cause miscarriage during pregnancy. Due to faster growth during pregnancy, along with interstitial edema and insufficient blood supply, fibroids may undergo degenerative changes. The combined effects of infarction, congestion, thrombosis, and hemolysis lead to blood stasis overflowing into the tumor, making the tumor red, known as red degeneration of fibroids, which can cause dull or severe abdominal pain. Conservative treatment is generally ineffective, and surgical removal of the fibroid is necessary. If it is a subserous pedunculated fibroid, the tumor is prone to torsion, causing acute abdominal pain, requiring emergency surgical treatment. Fibroids are less likely to occur in the submucosal layer of the uterus, and if pregnancy occurs, the submucosal fibroid may be expelled into the vagina with the fetus, even causing uterine inversion. If the fibroid is located low, it may directly obstruct the fetal head from entering the pelvic cavity, preventing vaginal delivery, or cause excessive postpartum bleeding due to poor uterine contraction (see Figure 3, Figure 4). If uterine fibroids are found before pregnancy, conservative or surgical treatment should be considered based on the size and location of the fibroids. (5) Ovarian tumors Benign ovarian tumors show no symptoms in the early stage and are only detected during gynecological examinations. If they occur during pregnancy, there may be a risk of pedicle torsion, requiring immediate surgical treatment, otherwise, it may lead to miscarriage or preterm labor.