Intervention Birth

Intervention may be required if the health of the baby or expectant mother is compromised at birth. Such deliveries are called "Intervention Birth". When it comes to intervention birth.

Birth induction: The most common intervention at birth is birth, and the labor process is accelerated by initiating or supporting it. Birth induction by giving certain drugs in serum is called “artificial pain”.

  • Episiotomy It is the name of “sewing at birth” as it is known among the people.
  • Forceps It is referred to as a "spoon" among the public.
  • Vacuum These are vacuum applications.

Birth Induction

The initiation or support of uterine contractions, ie birth pains with an external effect, is called "birth induction". The aim is to speed up the birth process.

All kinds of induction must be applied absolutely and under hospital conditions. There are three types of birth induction methods most often:

  • Amniotomy
  • Oxytocin infusion
  • Prostaglandin application

Amniotomy
The most common and natural induction is the opening of the amniotic sac of the baby, namely “amniotomy”. In this way, pain can start and strengthen both with some substances secreted in the body and the pressure of the baby's head directly on the cervix.

Amniotomy is a very frequently used method during vaginal delivery. However, if the action does not start within 24 hours after opening the membranes, the risks of infection will arise in the mother and the baby.Oxytocin infusion (Artificial pain)

Oxytocin infusion (Artificial pain)
The second method that is used for labour induction is to administer “synthetic oxytocin” intravenously. It is a process commonly called “artificial pain” among the public.

First, an extremely careful gynaecological evaluation should be made before deciding on induction, regardless of the reason and shape of the application. For this:

  • There should be no incompatibility between the baby and the mother's bone roof.
  • There should be no position anomaly in the baby.
  • Changes in preparation for childbirth must have occurred in the cervix.

The application is started at very low doses and the dose is gradually increased until the desired intensity and frequency reaches contractions. The patient and the baby need to be monitored very closely, as the uterus does not relax between the two contractions, which can have very dangerous consequences for both mother and baby.

Birth monitoring is done with NST, you see a pregnant woman who has undergone NST in the picture.

In NST, the baby's heartbeat and uterine contractions are printed on a graph paper at the same time. The upper part belongs to heart sounds and the lower part belongs to uterine contractions.

Prostaglandin application
The method of induction with another drug other than oxytocin is to initiate or accelerate the birth by applying substances called “prostaglandin” orally or vaginally.

Prostaglandins are usually applied to pregnant women who are past the day or who have been decided to evacuate due to abnormalities in the baby.

If the action does not progress despite birth induction or if symptoms of distress (stress) occur in the baby, then an emergency caesarean should be ended.

Episiotomy (Stitched birth)

Episiotomy: It is a birth intervention performed by cutting the perineum in order to deliver the baby's incoming part during birth without causing irregular tears in the vagina and as soon as possible. It is called "stitched birth" among the people.

Episiotomy incision is applied in almost all of the first births. Because the flexibility of the vagina in the first pregnancies is less than those who gave birth before.

Episiotomy incisions are most commonly mediolateral (cross) and median (perpendicular to the anus). Median incisions: it is preferred more frequently because of the low bleeding, easy healing and not causing problems in the later periods after recovery.

However, in cases where the incision needs to be extended, such as those with a short perineum, narrow pelvis roof and large baby suspicion, a mediolateral incision is preferred.

Forceps

Forceps are spoon-shaped tools used to deliver the baby as soon as possible. Although it is thought to have been used since ancient times, the entrance to modern obstetrics was in the 18th century.

The forceps are used in cases where the second stage of delivery is prolonged, if there is a problem in the baby, or in cases such as heart disease, where the mother is not suitable to be strained.

Forceps should be applied by physicians experienced in this field. Because the baby using forceps may have complications such as intracranial bleeding, partial paralysis, skull fractures, asphyxia, that is, oxygen deficiency in the birth canal, jaundice, and death.

With the use of forceps, vaginal, cervical, rectal tears, bladder injuries, bleeding and hematomas may occur in the mother.
In modern obstetrics, it is suitable to be applied only during hatching. In cases where the baby's head is above, delivery by caesarean should be preferred.

Vacuum

Vacuum Application reasons and complications are almost the same as forceps. Here, the baby is drawn with a bell placed on the baby's head and a vacuum device attached to it. It is easier to apply than forceps and less traumatic for both mother and baby.

Today, forceps and vacuum applications have decreased considerably with increasing cesarean delivery rates.

The birth event is the end of a process that has been patiently expected for 40 weeks.

Op. Sibel Malkoç, MD

Gynecology and Obstetrics Specialist

Dr. Sibel Malkoç attended many domestic and international training seminars and congresses during 25 years of specialised physician service.

Pregnancy follow-up, urinary incontinence surgery and laser treatments, genital aesthetic surgery and laser applications and vaginismus treatment are of special interest.

It serves its patients especially in surgical and laser-assisted Vagina aesthetics.

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