I. Avoid huge babies
Many people think that during pregnancy and after delivery, they should take a lot of supplements, but in fact, strengthening the body lies in the plain. Many pregnant women insist on eating all kinds of fruits every day (apples, grapes, oranges…) The family members of the family; or the mother-in-law let her eat hard and eat fat. Eventually give birth to a child is their own, more than 7 pounds of children, it is not good birth. Last night’s mother, 24 years old, was born 24 hours, 3800g, difficult shoulder labor, postpartum bleeding, at one point I decided to give her a cesarean section. The cesarean delivery by knife, pediatric asphyxia brachial plexus nerve damage, postpartum vaginal loosening across, suffering or pro-mother. Special attention, after the middle pregnancy recommended to strengthen the diet, at 36 weeks, ultrasound indicates that the fetus is no longer “small”, you should immediately control the mouth: eat less or no fruit, less refined rice, refined noodles, porridge, soup, hungry to eat some low-calorie tomatoes, vegetables and lean meat with high protein, too fat or estimated that the fetus is too heavy, even eat some konjac (not taro), as long as the urine ketone body negative and no hypoglycemia is good.
Pregnant women are usually referred to eat 70% full, not 10% full. In fact, for all people, should not eat too much, to leave some space for the stomach to move. Overfull, increase the burden on the spleen, spleen deficiency, people will be fat.
Second, fetal growth restriction and pregnant women who are thin
① One clay egg in the morning and one in the evening (egg custard is the most easily absorbed).
②Runcorn (ask the doctor to sign the order), 1 capsule each in the morning, midday and evening.
③Milk for pregnant women, one large glass in the morning and one in the evening, or milk powder in rice.
④ thick soup (it is advisable to add Dan Shen 12g or Chuan Xiong 12g,or consult Dr. Guo).
⑤ good quality seafood (such as fish glue, local chicken, sea fish).
⑥Rich fruits.
⑦Adequate regular meals, such as lean meat porridge, thick pork rib soup, and water fish. Pregnant women are required to gain 1-2 pounds of weight per week. For patients with poor appetite, it is often necessary to use evidence-based medicines to nourish the stomach and strengthen the spleen, such as nourishing stomach granules, Xiang Sha Nourishing Stomach Granules, Xiang Sha Liu Jun Wan, Tonic Zhong Yi Qi Wan, etc.
Pregnancy vomiting (refers to the early pregnancy period, severe nausea and vomiting, unable to eat)
Ginger or ginger juice or umeboshi, salt, rock sugar (if the stool is dry, add a large spoonful of honey), some ginger flavor, when water to drink frequently. If nausea and vomiting is obvious, you can increase the amount of ginger, and then add perilla leaves 5g, sage leaves can calm the fetus. Some people are prone to fire and many mouth sores, add some rock sugar + Huang Lian 3-5g, or Di Shen (also known as Zhi Mu 12g), or Bamboo Roo 9 (can clear heat and stomach), or lotus seed heart. Taking a multivitamin for 3 months before pregnancy can reduce the incidence and severity of pregnancy sickness. Vitamin B6 (10mg, q8h) or combined with doxylamine (10mg, q8h) is safe and effective in treating pregnancy sickness. Some people may eat some dry buns, cookies, or have some cold soup. In short, eat and vomit, vomit and eat again, and mentally overcome the disease.
Timely intravenous fluids, adequate amount of fluids and vitamins to ensure sufficient urine volume, energy, and reasonable nutrition are necessary. Some patients lack vitamin B1 for a long time, causing wernicke encephalopathy, the symptoms are very terrible. A urine ketone test is not necessary to diagnose severe pregnancy sickness. A pregnancy should be terminated if it is >120bpm, >38 degrees, wernicke’s sign, persistent jaundice, and persistent proteinuria.
Suppressing liver and lowering (and) stomach frequent drink (Su Ye Huang Lian Tang): Fetal qi rebellious upward through the rushing vein, offending the spleen and stomach, loss of harmony and lowering of the stomach, plus liver qi rebellious upward; ending in vomiting due to warmth and heat blocking the upper, spleen and stomach disharmony in the middle jiao. Because the Liver is intrinsically and closely related to the Chong Chakra; the descending ability of the Stomach is weakened.
Su Ye: Huang Lian 3-5, Chen Pi 5, Han Xia 6, Jiang Zhu Ru 6-9. If vomiting is intense, add roasted Wu Mei 3-5, Hooked Vine 12, ginger 2-3 slices.
Huang Lian is an important medicine to suppress the liver, Su Ye replaces the cornelian in Zuo Jin Wan, both of which can be used to support gold and pacify wood, and Su Ye can calm the fetus. Radix et Rhizoma (Dan Pi) is a forbidden medicine for pregnancy and can cause fetal malformation. Bamboo Roo can clear heat and harmonize the stomach. Suitable for: ① menstrual vomiting: with chest tightness and irritability, dizziness and headache, lumbago, distension of the abdomen and stomach, firm stools, low menstrual flow in late menstruation, purple-red color with lumps, slippery pulse, dull red tongue, yellow and white greasy coating, add Salvia miltiorrhiza, Radix et Rhizoma Paeoniae, Zeleniae 10, and Radix Aromaticae 9. ② acute and chronic vomiting: vomiting yellow bitter water or mucous phlegm, or mild fever, unclean diet, slippery pulse, yellow and greasy coating, Scutellaria baicalensis 10, Mucuna pruriens 9, Glycyrrhiza glabra 10, and even Rhizoma macrophylla (after (below) 6.
If liver fire is exuberant with headache and dizziness add hooked vine 15 Tribulus terrestris bitter tea 10.
If the phlegm-dampness is very high, vomiting and mucous phlegm is very high, the stomach is stuffy, the fur is white and greasy plus dry ginger 5, Ling 12, patchouli 6.
If the heart fire is strong, the heart is troubled and sleep is poor, and the tongue has sores, add lotus seed heart 5, green dragon tooth (first decoction) 10, if necessary, add Huang Lian amount.
IV. Anemia
Iron supplementation is the first priority, such as raw blood nin, speedy fei, Liguaneng, soapfanta, etc., eat 1 hour before meals to avoid eating with vegetables. Take iron-containing milk powder with multivitamin tablets. Dietary supplements (such as chicken blood and pork liver) are not a substitute for iron supplementation medications, and red dates are not recommended for people who are prone to fire. Dr. Guo will also give the patient some Chinese herbal medicines, such as sour date palm 15, gum powder 12, angelica 9, a few slices of dried orange peel, 5 lotus seed hearts, put half a bowl of water, rice pot steam, all eaten. For hot body with nosebleeds or mouth sores, use Zhi Mu 12 Corn Husk 20 Atractylodes Macrocephala 12 Scutellaria Baicalensis 12g in decoction. Monthly blood tests are also required. Some pregnant women do not pay attention to this and prescribe 3 boxes of medicine and finish them in 2 weeks; as a result, 2 weeks after the delivery, they say there are still 2 boxes of medicine at home, in this way, the anemia is definitely not corrected. Those with obvious anemia should be admitted to hospital with 15ml of iron sucrose + 250ml of saline VD 1h/day intravenously. Anemia is an easily treatable disease during pregnancy, much easier compared to other diabetes, hypertension, rash, cough, but without proper medication, the more anemic you are, the more likely you are to bleed and even have a blood transfusion. God will not say: Oh, this person is anemic herself, let’s make her bleed less. For rare blood types and bleeding patients (placenta praevia, multiple births, etc.), special attention is needed.
V. Excessive amniotic fluid
Blood deficiency and weakness of the spleen evidence: thousand gold carp soup + prevent has astragalus soup: return peony lingzhi wolfberry 10-15 each, astragalus prevent 10-15, carp 1. The carp Fangqi move water and reduce swelling, Astragalus benefit Qi and strengthen the table to move water and reduce swelling, Atractylodes nourish Qi, strengthen the spleen and dispel dampness, increase the power of Qi to strengthen the table, and Fangqi match, the function of dispelling dampness and moving water doubled. Poria invigorates the spleen to regulate dampness in order to move water, and Radix Paeoniae nourishes the blood to calm the fetus, so that the water moves without harming the Yin and blood. Carp, cleaned of bones, decoction of soup and boiled on the drug. When the amniotic fluid is particularly large, add psyllium pigling to facilitate water. Spleen qi deficiency is very plus party ginseng 15 roasted licorice 6 wide mucuna pruriens 5, kidney deficiency, plus Xian Ling spleen 9, cinnamon 3 (after the next) spleen and kidney Yang deficiency evidence: form of cold, waist and leg weakness, poor nausea and fatigue, abdominal distension and loose stools, urine volume is small, light tongue with white fur, smooth pulse. The symptoms of deficiency of kidney and yang in amniotic fluid can be treated with Jin Kui Kidney Qi Pill. In late pregnancy, add blood invigorating herbs such as Salvia miltiorrhiza, fried Angelica sinensis, Paeonia lactiflora, Chuanxiong rhizome and even roasted cinnamon stick, amber and Zeilan leaf to facilitate delivery.
Simple method: winter melon skin (more than half a catty) + barley (about 1 tael) + poria, gradually good, thirsty soup to eat slag; but do not eat every day, 3-5 days ultrasound review.
Six, too little amniotic fluid
It is recommended to drink more water, warm salt water, 250ml, 5 minutes to finish, about 2000ml per day, or use several flavors of the following remedies (such as Sha Shen, Yu Zhu, Tian Dong, Dendrobium, Atractylodes, Radix Platycodon, Radix Codonopsis), decocted into water, drink frequently.
It is caused by deficiency of yin and blood and deficiency of fluid after pregnancy. Yin deficiency and fluid deficiency: Consistent decoction + Sha Shen Mai Dong Tang: Sha Shen raw and ripe ground Xuan Shen 12 Mai Dong 9 Dendrobium 12 White peony and Chinese wolfberry 10, Golden belladonna 6 rhizome 15. for dizziness and headache irritability, add fried gardenia 9 hooked vine 15 chamomile 6; for very poor night sleep, add lotus seed heart 3, nightshade 15 fried jujube 9. for leakage of sticky fluid, add roasted turtle plate (first decoction 20) oyster 15 gorgonian 10. for spleen deficiency and blood deficiency: fatigue, weakness, frequent vexation, tongue and breath. The symptoms of spleen deficiency and blood deficiency include fatigue, frequent vexation, light red tongue, thin white fur, and slippery pulse. The symptoms of spleen deficiency and blood deficiency are: fatigue, frequent attacks of yawning, pale red tongue, thin white fur, slippery pulse. The medicine: Mai Wei Di Huang is suitable for the evidence of yin and fluid deficiency. Ten whole tonic cream is suitable for the evidence of deficiency of both qi and blood.
VII. Prevention of vomiting before cesarean section
The strict preoperative fasting requirement is 8 hours of fasting and 6 hours of drinking. In common parlance, it is not to eat or drink for more than 6 hours. Some patients, instead of eating, go to eat noodles; or do not eat, but make an effort to drink water and milk, or eat fruit. Some other family members, thinking that they cannot eat for quite a long time after the operation, let the patient eat a lot before the operation, which is actually a big mistake. This requirement should be even stricter for those who use general anesthesia; the reason is that under anesthesia, the coughing response is suppressed and vomiting can easily occur, and the vomit can easily be inhaled into the lungs instead of being discharged through coughing. If aspiration pneumonia occurs, the patient will not die, but lose half of his life; if not, he will be in the hospital for half a month at a cost of ten thousand dollars.
In fact, a considerable number of cesarean sections are performed in an emergency. For example, during vaginal trial of labor, patients are often encouraged to eat thirsty sports drinks to enhance physical strength; once there is prolonged labor or abnormal fetal heartbeat, amniotic fluid and fetal fecal contamination (or called fetal distress), emergency surgery is required; the patient has a full stomach, and it is very dangerous to do anesthesia at this time. When I was in Xinjiang, the anesthesiology department required the obstetrics department to routinely insert a gastric tube through the nose for those who did not meet the fasting and drinking standards, and the patient was very uncomfortable; during surgery, the patient always unconsciously used his hands to find this tube; and when it was inserted, nothing seemed to be drained. This contradiction is still medically difficult to resolve; the medical risks faced must also be understood and borne (in part) by the patient.
Under general anesthesia (tracheal intubation + intravenous anesthesia), the patient is deeply asleep, while under anesthesia for a cesarean section, which is usually semi-corporal, the patient is awake because after the fetus is delivered, the mother needs to confirm the sex of the baby and say so. I often look into the patient’s eyes during the cesarean section, especially before cutting the uterus, and ask them how they feel – I have to make my patient understand that her attending surgeon is confident, is concerned about her (the person’s) feelings, and has a grasp of the whole picture and is able to prevent risks and accidents. Therefore, the patient is awake and can feel the physician “doing it”, but without pain. In a few cases, general anesthesia may be required due to mental and emotional problems or the inability to perform a lumbar puncture.
There are often patients who talk incessantly during the procedure and then become very bloated afterwards. Some postoperative or excited to talk non-stop, or always tell others how to do things, talk too much, and abdominal distension is also very serious.
Eight, postoperative prevention and control of abdominal distension
Routinely avoid eating within 6 hours. For those who are especially thirsty, Dr. Guo Peifen usually agrees that patients should be thirsty for one sip in one hour, which can be a big sip, but not more than one; that is to say, when you come back from surgery at noon, you should drink only 6 sips of water until 6 pm. You can also drink some thin porridge water, not rice grains. The next day, you can eat semi-liquid such as porridge, a small half bowl at a time, and another half bowl an hour later. Some patients immediately eat in large bowls as soon as they hear the physician agree to her eating. If she eats, it is difficult to come out, and even intestinal obstruction occurs, requiring a gastric tube through the nostril and fasting for several days.
After cesarean section, the gastrointestinal function to recover slowly, should be a liquid diet for 1 day, after the situation improves, switch to a semi-liquid diet for 1 to 2 days, and then switch to a normal diet.
For patients with abdominal distension: prevention Avoid eating too early and too much after surgery; turn over more often to promote intestinal peristalsis and prevent intestinal tube adhesion; use 40ml of open plug in the anus early to promote defecation and exhaustion; drink some Chen Pi + radish seeds (Lycopodium) water or Hou Pao Hopping or Si Mo Tang; ultrasound instrument treatment; abstain from flatulent foods such as milk, soy milk and large amount of sucrose; when abdominal distension is obvious, take abdominal standing X-ray plain film in time. Treatment (1) Once obvious abdominal distension or incomplete intestinal obstruction occurs, fasting (several days) should be performed; gastric tube via nostril, continuous gastrointestinal decompression, potassium and vitamin supplementation via gastric tube with some vegetable juice or infusion; maintenance of water-electrolyte balance, potassium supplementation 6-8 g/d, intravenously or diluted with ice water and intermittently injected via gastric tube; nutritional support, early parenteral nutrition; use of growth inhibitors, gastrointestinal glands and pancreatic secretion, corticosteroids to promote intestinal inflammation and edema subsidence; omeprazole to prevent stress ulcers, 1 to 2 times/d for 5 d; broad-spectrum antibiotics for 1 to 2 weeks. (2) Ancestral medicine: use the treatment of Tongli tapping, moving Qi and relieving pain, such as Si Mo Tang (Shen Xiang Mu Xiang Betel nut Wu Yao) or Cheng Qi Tang with addition and subtraction, and rhubarb retention enema. (3) Surgical treatment. If the body temperature continues to rise and abdominal pain and distension progressively increase, prompt surgical investigation should be performed.
Diet for diabetic patients: regular, quantitative, small and multiple meals; adjust the amount of insulin before meals according to the amount of meals eaten. Low heat is preferred over food.
Nine, after natural childbirth
New mothers should be light, easy to digest, nutritious soup soup-like food, such as hot lean pork porridge, hanging noodles lying eggs, ginger brown sugar water lying eggs, lotus root and pig’s foot soup, millet thin rice; diabetic patients can eat sugar after delivery, but should eat less. 3 days after delivery should still be vegetables, fruits, eggs, thin rice, noodles, etc.. Avoid raw, cold, spicy (chili) and stimulating food; for those who need to breastfeed, avoid eating pig liver porridge, old hen, hawthorn, etc. Some customs prohibit women from eating vegetables and fruits, and as a result, they do not poop for ten days. In the past, it was mainly thought that vegetables are colder, breastfeeding women eat, may lead to infant diarrhea, in fact, it is not. Try to have less chicken oil and lard, too much oil, easy to cause diarrhea and abdominal pain (stainless steel spoon containing ice cubes, in the surface of the hot soup over, the oil is frozen under the spoon, wipe away). Fruit, eat after meals, peel edible bananas, oranges better, need to wash apples, grapes, if not washed clean, easy to cause diarrhea. 1 day eating 5-6 eggs, is also inappropriate, bad digestion, easy to abdominal distension. Yellow wine, damp and hot body do not eat, cook more for a while, a small amount of yellow wine, rice wine or can eat, but also pay attention to the reaction after eating. Diabetic patients will follow the dietary advice of the nutrition department.
For mothers with severe perineal lacerations and stitches, it is usually necessary to fast for 2-3 days, followed by a diet with less residue for 2-3 days (mainly referring to various meat soups, vegetable juices, rice soup, fruit juice, noodle soup, noodle soup, milk, yogurt), and then a semi-liquid diet for 3 days (thin, soft, rotten, easy to digest, easy to chew, containing little coarse fiber, without strong stimulation). Semi-liquid foods include: minced meat porridge, minced vegetable porridge, egg flower porridge, thin fish fillet porridge, wontons, bread; steamed egg custard, egg flower soup, lying eggs; tender tofu, tofu brain; fruit puree, jelly; watermelon, cooked banana; vegetable puree, tender chopped vegetable leaves; tender shredded meat, etc.
After 3 days, you can enter soft food or ordinary diet according to your digestion. When the mother has relieved herself of stool, she can eat stewed meat soup, fish soup, chicken soup and other foods.
The following recipes can be used for maternity and weakness
Astragalus membranaceus and japonica rice porridge: decoct Astragalus membranaceus 30g 3 times, remove the dregs and take the juice, cook with japonica rice (also fresh Huai Shan in half) for porridge, then add Chen Pi 3g and boil slightly, then add brown sugar. Eat once a day for 5 to 7 days. It is better for postpartum gas deficiency type of dew (light red dew, thin quality, feeling tired and dizzy at times).
Sea cucumber and beef soup: Soak sea cucumber (appropriate amount) and wash it, slice beef, then put it into a pot together and cook the soup until the beef is done. Serve warm. Sea cucumber nourishes kidney and essence, nourishes blood and moistens dryness, suitable for essence and blood deficiency, weakness, kidney deficiency and frequent urination, intestinal dryness and constipation, etc.; yellow beef is sweet and warm in nature, nourishes middle and middle energy, nourishes spleen and stomach, and strengthens tendons and bones. Therefore, the two things stewed together as soup to drink, can supplement the postpartum weakness of qi and blood, a hundred sections of empty disease.
Chicken feet peanut soup: 8 chicken feet chopped open, boil over high heat, put a tablespoon of cooking wine without a lid, boil again, fish out and wash the spare. Wash the peanuts and red dates, and slice the ginger. Put all ingredients together in a pot and boil for 1 hour. Season with salt and pepper, and continue for another half hour. You can add sesame oil or cilantro according to your preference.
Chicken stew with Chinese angelica
Half a hen, 30 grams of angelica, l00 grams of astragalus (incorporated into the chicken’s belly), add the right amount of water, stew, oil and salt to taste, drink the soup and eat the meat, suitable for regulating postpartum hemorrhage. As the maternal gastrointestinal tract function is affected by pregnancy hormones and enlarged uterus, peristalsis is inhibited, establishing the patient to adhere to the principle of small and frequent meals.