The reason for the vertical incision being easier for extraction is the sa: generally, in the uterus of the mother, the fetal head-down position offers a more open view for the doctor, unlike the horizontal incision where the doctor’s view and operation are restricted in every way.
Since beauty is important to won, most obstetricians, thinking of their female patients, continue to challenge themselves with the horizontal incision for fetal extraction. When facing difficult fetal extractions, clever solutions must be employed.
For example, if the fetal head is high and hard to extract, the surgical incision can be moved upward.
Today’s patient has a highly floating fetal head, with so distance from the incision. When the doctor reaches into the patient’s uterus, it’s not only difficult to grasp but also easy to push the fetal head further into the uterus. The problem is that moving the incision upward increases the exposure on the abdon, making the scar appear very noticeable. In such cases, a vertical incision would be preferable. Therefore, bold obstetricians do not casually move the incision upward. Today’s Chief Surgeon, Director Yoo, a veteran of countless battles, certainly wouldn’t do that.
If you don’t move the surgical incision upward, you need to find other ways to solve the problem.
Clinically, many experiences and thods have been summarized to address this.
If the fetal head is away from the incision and floating high, one can press down on the fetal head to make it descend to the designated position. So, with Doctor Peng’s hand placed at the uterine fundus to nudge it, the goal is to bring the fetal head close to the incision for the chief surgeon to extract easily. If there’s enough space inside the uterus, the doctor might even rotate the fetus half a turn; if the head doesn’t erge, they can expose the fetus’s buttocks first, grasp the baby’s feet and pull the baby out, separating it from the mother.
Doctor Peng pushed with effort. After a couple of pushes, he realized this baby seed unfazed by the doctor’s efforts, reluctant to co out. Simply pushing the fundus might take a long ti, and ti was running out, so he urgently called out, "Forceps, forceps."
The doctor couldn’t push with enough force, like a cart not moving, and had to rely on pulling force from the front. Forceps can grip the baby’s head to pull it forward. The only problem is that forceps might damage the baby’s head.
Director Yoo didn’t imdiately grab the forceps but instead inserted two fingers into the patient’s uterus to see if she could manually guide the baby’s head. Her hands, being sowhat larger, had difficulty entering to operate.
"Don’t rush, stay calm," Director Yoo said to the other doctors, determined to stabilize the situation.
The anesthesiologist ca over; Doctor Peng couldn’t push alone, so another person ca to help.
Director Yoo shouted to the anesthesiologist, "No need, you keep an eye on the patient’s vital signs."
This patient was slightly malnourished, worried about potential surgical accidents, and the anesthesiologist might be too busy, so it’s best for them to monitor the patient alone.
Imdiately, Director Yoo instructed the two students: "You, go help Doctor Peng."
Following the teacher’s orders, Xie Wanying imdiately went opposite Doctor Peng, ready to assist with pushing the uterine fundus.
"Put your S-hook in."
Geng Yongzhe’s entire body stiffened, and despite his calmness, he was afraid.
This hook had to be placed beneath the child’s head; carelessness could harm the baby’s head. Anyone with dical training knows that compared to adults, a baby’s head is fragile, the fontanelles are not closed, and the neck is very soft.
"Co," Director Yoo guided his hand to place the hook.
The S-hook was inserted to press the uterine fundus, utilizing the lever principle to lower the fetus. At this point, with additional rear pushing force from two other doctors, success followed more quickly. Yet clinically, many babies don’t play by the rules and don’t follow the doctors’ intentions.
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