Metrals


Metratester in the uterine cavity.

Metrals - obstetric surgery, in which the cavity of the pregnant uterus to enhance labor activity impose metratester - rubber cylinder (Fig.). Operation is performed by a doctor.
Indications: the transverse position of the fetus; a presentation or prolapse of the umbilical cord; weakness generic activities; failure to discharge of water during fetal pelvic presentation; bleeding during placenta previa; the need (disease of the mother of abortion after 16 weeks.
Contraindications. The risk of uterine rupture! Former surgery on the uterus, eclampsia or eclampsia, inflammation of the uterus and the genital tract.
After the introduction of metratester midwife watching labor, childbirth, discharge from the vagina. In case of occurrence of bleeding, leaking water, the fluid outflow of metratester or damage to the last - immediately signal the doctor.

Metrals (metreurysis; from the Greek. metra - uterus and eurys - wide) - obstetric surgery, which consists in the introduction of the cavity of the pregnant uterus of metratester - rubber cylinder intended for the disclosure of the cervix. Metrals used to produce a significant expansion of the cervical canal mechanically and cause or intensify the fight reflex effect on the receptors of the lower segment and cervix. Metrals used to be pressed to the wall of the uterus flaking predlagay placenta and thus to stop bleeding.
There are different models of metratester. In the USSR almost exclusively use pear metratester (see Obstetric-gynecological tools).
Indications: abortion after 16 weeks; stimulation of premature birth and birth in advanced pregnancy; weakness generic activities; the transverse position of the fetus (adequate cervical opening and subsequent rotation fruit on foot); rigidity of the neck. of the uterus, prolapsed umbilical cord after it napravleniya; the placenta previa. Metrals used quite rarely and when some of the above indications (placenta previa, cross the fetal position, interruption of pregnancy in the second half and some others) produce a caesarean section.
Metrals can be used only under the following conditions: no infection of the birth canal (purulent discharge, coleitis, endometritis); the absence of a uterine scar after former cesarean section or enucleation of myomatous nodes; no severe nephropathy and eclampsia; mobility predlagay part of the fruit; during the opening of the cervical canal at least 1½ finger. When closed her neck extend pre-expanders, Chegara to # 20 (contraindicated with placenta previa because of the possibility of rupture of the uterine cervix.
Technique: after disinfection vulva vagina impose a wide mirrors, seize the tongs Muse and reduce the vaginal portion of the cervix. The size of metratester choose depending on what value the disclosure cervix to get. Metratester pre-sterilized, roll in the form of cigars, seize special forceps or bend forceps and impose internal Zev. After the introduction in the lower part of the uterus of metratester pick off and remove the tongs and mirrors. Over the discharge tube through a large syringe metratester filled with saline. The number of input solution must comply with the input capacity of metratester. Outlet tube filled metratester clamp and an end to suspend the cargo 200-500,
There are two ways Merarite. In some cases metratester enter without disturbing the integrity of amniocentesis bladder - extraocular (Fig. 1). This method, in particular, preferably in the transverse position of the fetus; in its application are stored water and mobility of a fetus, which is important for the subsequent turn it on foot. In other cases, metratester enter after preliminary autopsy shells - intraoculara (Fig. 2.) This method is more efficient, and with placenta previa is absolutely necessary.
Metratester can remain in the uterus no more than 8-10 hours. After that from him release the fluid, remove it and examine the vagina. If the extension of the cervix is still not enough, metratester disinfected and introduce at the same time again. The inefficiency Merarite it, often combined with intravenous drip of pituitrin (oxytocin).

Fig. 1. Metratester in the uterine cavity (introduced extraocular)
Fig. 2. Metratester in the uterine cavity with placenta previa (introduced intraocular).