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Abstract: After this pregnant woman quarreled with someone and cried a lot during late pregnancy, which led to the occurrence of fetal ischemia and hypoxia symptoms, frequent fetal movements, which in turn led to 2 turns of the umbilical cord around the neck, further aggravating fetal ischemia and hypoxia, and eventually fetal distress occurred. She was admitted to the hospital and treated with left lateral position, oxygen and rehydration, which effectively relieved the symptoms of fetal distress.
Basic information】Female, 25 years old
Type of disease】Cord winding
Hospital】Jiangbin Hospital of Guangxi Zhuang Autonomous Region
Date of consultation】March 2022
Treatment plan】Left lateral position + oxygen + medication (sodium lactate Ringer injection + vitamin C injection)
Treatment period】4 days of hospitalization
Effectiveness of treatment] Symptoms were controlled and fetal distress symptoms were relieved
I. Initial consultation
The pregnant woman reported that her last menstrual period was on June 15, 2021, and the ultrasound showed early intrauterine pregnancy in the second month of menopause, and the expected delivery date was March 22, 2022. She started to feel fetal movement at 20 weeks of gestation, and her labor and delivery went smoothly, with no significant abnormalities in Down screening and systemic ultrasound. At 28 weeks of pregnancy, the ultrasound showed that the fetus was wrapped around the umbilical cord, and it was recommended to count the fetal movement every day. On March 5, she had a quarrel with someone and cried a lot in the morning, then did not eat breakfast or Chinese food, and started to have occasional lower abdominal distension and fetal movement at 13:00, which was not relieved after rest. The results indicated that the umbilical cord was wrapped around the neck for 2 weeks and the S/D value of umbilical blood flow was increased.
II. Treatment history
After admission, the pregnant woman was informed that bad behaviors and emotions such as quarreling, anger and crying have a great impact on the fetus, and when the pregnant woman has bad emotions and does not eat, the blood supply to the placenta will also be significantly affected, leading to the occurrence of fetal ischemia and hypoxia symptoms and frequent fetal movements, and frequent fetal movements will lead to cord winding and stimulate contractions, which will further aggravate ischemia and hypoxia and lead to fetal distress, so in order to relieve fetal Therefore, in order to relieve fetal distress, the first step is to relax and maintain a calm state of mind. Therefore, in order to relieve fetal distress, first of all, we should relax and keep a calm mind. Treatment with left lateral position, oxygen and intravenous infusion (sodium lactate Ringer injection, vitamin C injection) can help to reduce the symptoms of intrauterine hypoxia, and encourage pregnant women to eat less and more meals, some nutritious, light and easy to digest food, as well as fresh fruits.
III. Treatment effect
After giving symptomatic treatment, the pregnant woman could sleep quietly at night, and the fetal movement gradually returned to normal the next morning. Four days after admission, the fetal movement was normalized by self-counting, the fetal heart monitoring was normalized, the maternal-fetal blood flow ultrasound indicated that the umbilical cord was wrapped around the neck twice, and the umbilical blood flow S/D value was normal. Since the fetus was already at full term, there was relatively little room for fetal movement in the uterus, so the amplitude of fetal movement was generally not large, and it was unlikely that the cord was loosened.
IV. Notes
We are glad that after a series of treatment, both the pregnant woman and the fetus are safe, but after discharge, we still need to count the fetal movements, and keep a good state of mind to avoid great joy and sadness, and our family members should provide timely guidance, in addition, diet and exercise are also very important for the late pregnancy.
1, it is recommended that pregnant women must count fetal movements every day, and if they find that fetal movements are significantly increased or decreased, they should immediately return to the hospital for consultation.
2, relax, maintain a good state of mind, do not keep things in your heart, communicate with your family and friends, or do something you like to distract yourself.
3.Be sure to strengthen the regular maternity checkups, it is recommended to review the fetal heart monitoring every 3 days at the outpatient clinic, and check the ultrasound every 7 days until delivery.
4. It is recommended that pregnant women pay attention to scientific and reasonable nutritional intake, pay attention to calcium supplementation, never diet, and be properly active in the late pregnancy.
V. Personal insight
In late pregnancy, as in the case of the pregnant woman, the psychological and physiological burdens will increase significantly, due to the fear of the delivery method, fetal safety, labor pain, etc., easily bring anxiety, fear, depression and other adverse emotions, and these psychological problems often do not attract the attention of the people around, so more often take some angry way to vent, but anger has a greater adverse impact on the fetus, and may even lead to cord bypass, fetal distress, preterm delivery. This can even lead to cord bypass, fetal distress, premature birth, etc. We should care more about this special group of pregnant women and help them get through pregnancy smoothly.