Focus on high risk abortion

The subject of high-risk induced abortion and its danger are as follows:

(1) Age <20 years old or> 50 years old: Any person requiring termination at this age group should be hospitalized and have experienced doctors perform surgery. Because the <20-year-old girl's reproductive tract has not yet matured, preoperative preparations are required, such as placing cervical dilators to expand the cervix, otherwise it will lead to uterine injury.
For pregnant women aged 50 or over, because they have entered menopause, the elasticity of the genital tract is weakened and the cervix is ​​hardened, which is not conducive to surgical operations. It should also be hospitalized and the cervix dilator should be placed before surgery, otherwise it will cause the genital tract. damage.

(2) Within six months of the termination of pregnancy, there are two history of abortion within one year: At this point, the uterus has not fully recovered, and then the uterus is softer after pregnancy and is prone to uterine injury.

(3) After cesarean section or within 1 year after childbirth: There is a scar on the uterine wall after cesarean section. Within 1 year, the uterine wall has not yet fully healed. After pregnancy, the wall of the uterus is thinner. It is easy to perforate from the scar. To prevent perforation, preoperative pregnant women should go to the hospital to tell the doctor what time to do cesarean section; what surgical methods, such as classical, lower uterine or extraperitoneal cesarean section; postoperative fever, incision with or without infection Make doctors know how to take the necessary surgical measures to make the operation safe.

Pregnant women who are breast-feeding within 1 year postpartum are pregnant and their uterine walls are relatively thin and soft, and they are also easily perforated during abortion.

(4) Genital malformations or pelvic masses: The incidence of genital malformations associated with pregnancy is only O. About 14%, but it is also unfavorable to the operation. If a person with a pre-existing condition knows that they have a genital tract malformation before surgery, they should take the initiative to tell the doctor. The doctor should also check carefully to clarify the type of genital malformation, such as double uterus, double horn uterus, mediastinal uterus, vaginal mediastinum, etc. Corresponding measures, such as dual uterus, doctors should do two intrauterine suction surgery to prevent vaginal bleeding after surgery.
More common in clinical uterine fibroids with pregnancy. As uterine fibroids often make the uterine cavity deformed and become larger, cervical fibroids will cause more difficult operation. This doctor should be careful and careful surgery, if necessary, under B ultrasound surgery to ensure the safety of pregnant women.

(5) Patients with high degree of uterine position flexion or cervical dystrophy: it will bring difficulties to the operation and should be treated by an experienced doctor. Preoperative cervical dilatation sticks are used; intravenous anesthesia or analgesics are used during surgery, and safety is better if under B ultrasound.

(6) There were placental adhesions and major bleeding in the past pregnancy: this operation can still cause bleeding due to placental tissue adhesion to the uterine wall. Therefore, good blood type and well-matched blood should be performed before surgery. If there is bleeding, blood transfusion and contractions should be given immediately. Agent treatment to ensure safety.

(7) There is a history of submandially perforation or history of vaginal cervical puncture: During this operation, perforation may occur again at the original perforation site. Therefore, all preparations should be done before surgery, if necessary, use appropriate anesthesia, or put cervical dilatation sticks, etc., in order to ensure the safety of the operation.

(8) Spine, lower extremity, and pelvic lesions can not be taken bladder lithotomy lying position: will bring great difficulties to the operation, but also easy to make the surgery is not complete or bring about a secondary injury. If necessary, general anesthesia can be used to correct the position and should be operated by an experienced doctor to prevent accidents.

(9) Those who have a history of serious organic diseases or have a history of hemorrhagic disease in internal medicine: They should be hospitalized. If necessary, they should consult the relevant department so that the subject can be properly handled.

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