2020年11月23日星期一

what does a hemorrhoids look like,Those common surgical diseases that affect pregnancy

    Xiao Li has been married for three years. It is still two people whose parents are looking forward to returning home during the Mid-Autumn Festival. Under the urging of his parents, the young couple recently planned to give birth to the next generation. However, they saw that his colleague Mai was pregnant for 4 months and was hospitalized three times. Xiao Li suffered from insomnia. Knowing what kind of examinations you should do, in fact, the diseases that affect pregnancy are nothing more than gynecological diseases, surgical diseases and internal diseases. Here I will talk to you about surgical issues.

    1. Why are pregnant women easy to get hemorrhoids

    The uterus gradually enlarges during pregnancy, which increases the abdominal pressure and increases the pressure of the inferior vena cava. Especially when the fetal position is not correct, the compression is more obvious, which hinders the venous return of the lower rectum and anal canal, leading to the expansion of the hemorrhoidal venous plexus; The effect of endocrine can cause pelvic and rectal blood vessels to dilate and make hemorrhoids worse. In addition, pregnant women's activity is reduced and gastrointestinal peristalsis slows down, which can make the feces stay in the intestinal cavity longer, leading to constipation. Difficulty in defecation can aggravate the onset of hemorrhoids. Once again, the perineum rages during childbirth, which can aggravate the hemorrhoidal veins. The reflux disorder causes the hemorrhoids to prolapse, cannot be received, the pain is obvious, and even thrombosis, which affects the recovery of the postpartum body. Usually, the mothers who have worsening postpartum hemorrhoids disease usually have hemorrhoids before pregnancy, but they are mild and have no symptoms. Therefore, it is best to receive anorectal examination and treatment before and after pregnancy.

    2. Do you need appendix surgery before pregnancy with chronic appendicitis?

    Chronic appendicitis features: pain in the right lower abdomen, which is characterized by intermittent dull pain or distending pain, which is heavy and light, and the location is relatively fixed. Most patients induce abdominal pain after eating, exercising, fatigue, cold and standing for a long time. Patients often have varying degrees of indigestion and decreased appetite. Longer course of the disease may appear wasting and weight loss. Tenderness is the only physical sign, which is mainly located in the lower right abdomen, usually in a small area, and in a constant position. It can only appear when there is heavy pressure.

    It is divided into two types: primary and secondary. Primary chronic appendicitis has an insidious onset, slow development of symptoms, intermittent attacks, and the course of the disease lasts for several months to several years. Secondary chronic appendicitis is the onset of acute appendicitis for the first time, which is cured or relieved spontaneously after non-surgical treatment, and there are clinical symptoms thereafter, which can not be cured for a long time, and may have another or multiple acute attacks during the course of the disease. After the diagnosis of chronic appendicitis, surgical treatment is required in principle. First, due to repeated episodes of chronic local inflammation, abdominal adhesions are increased, which affects pregnancy. Once again, due to the physiological changes of pregnant women, they are prone to acute attacks during pregnancy. Once appendicitis occurs, the risk is greater than that of ordinary adults. Appendicitis during pregnancy will be more difficult to handle. According to statistics, the mortality rate of acute appendicitis during pregnancy is 2%, which is 10 times higher than the average person. It is better to choose laparoscopic appendectomy.

    3. Does pregnancy affect hernia?

    Hernia is caused by weak abdominal wall or high abdominal pressure. Pregnancy will increase the pressure in the abdominal cavity, weaken the abdominal muscles, and enlarge the hernia ring, which makes it easier for the small intestine, omentum, ovaries and fallopian tubes to break out through the weak points of the abdominal wall, increasing the risk of serious complications of the hernia. It is recommended to get pregnant as soon as possible operation treatment. Hernia recurrence often has internal causes: such as chronic cough, overactive bladder, chronic cystitis, constipation and heavy physical labor, and other factors that increase abdominal pressure. Pregnancy can increase abdominal pressure and constipation may occur, so surgery It is recommended to use a tension-free hernia repair with a patch.

    4. Female ureteral stones

    Because the female ureter passes through the base of the broad ligament of the uterus, the peristalsis of the ureter slows down after pregnancy, which can cause renal ureteral hydrops and stones, causing renal colic, frequent urination, urgency, dysuria and microscopic hematuria, often accompanied by nausea and vomiting , Can cause contractions and abortion. Large stones that do not affect the flow of urine may only have dull pain and light hematuria. Larger or rough-surfaced stones are easy to be incarcerated in the ureteral strictures and cause severe obstruction. Acute anuria and even renal insufficiency can occur. Urine flow above ureteral calculi can cause obstruction and dilatation of hydrops, and may be complicated by infections above obstruction, and cause renal function damage. In severe cases, renal function may be gradually lost. It should be sent to hospital for emergency treatment.

    5. Pregnancy with acute cholecystitis

    The incidence of acute cholecystitis and gallstone disease during pregnancy is second only to acute appendicitis. During pregnancy, under the action of progesterone, the gallbladder and biliary smooth muscle relax, causing slow emptying of the gallbladder and cholestasis; estrogen reduces the sodium regulation of the gallbladder mucosa, reducing the ability of gallbladder mucosa to absorb water and affecting the gallbladder concentration function; plus cholesterol in the bile The increase in ingredients reduces the secretion of bile salts and phospholipids, which is conducive to the formation of gallstones. Pregnancy is an important cause of cholecystitis and gallstones. Clinical manifestations: Colic occurs in the upper right abdomen, and gastrointestinal symptoms such as nausea and vomiting are often present. When the condition is severe, there are chills, fever, and colic in the right upper quadrant. When severe infection is accompanied by cholangitis, about 11% of patients develop jaundice. Should be hospitalized for active treatment. If the effect of non-surgical treatment is not good and the condition has deteriorated, or if gallbladder empyema, gallbladder perforation and diffuse peritonitis are complicated, surgical treatment should be performed as soon as possible. Laparoscopic resection of the gallbladder in the early and second trimester of pregnancy is safer for mothers and children and has no obvious adverse effects on pregnancy.

    6. What diseases can be complicated by hyperthyroidism during pregnancy?

    The typical manifestations of hyperthyroidism are summarized as follows: protruding eyes, thick neck, excited appearance, fear of heat, excessive sweating, hand tremors; diarrhea, easy hunger, muscle weakness, palpitations, weight loss, menstrual disorder; benign exophthalmos without feeling. There are many symptoms of malignant exophthalmos. The diagnostic criteria for hyperthyroidism are: hypermetabolic syndrome and elevated serum total thyroxine. The degree of control of the course of hyperthyroidism determines the prognosis of the mother and fetus. If you suffer from hyperthyroidism before pregnancy and have been well controlled, or if hyperthyroidism is found early in pregnancy for reasonable treatment, the prognosis for both mothers and babies is generally good. If the mother is still in hyperthyroidism until the second trimester, the complications of the mother and fetus or newborn increase significantly.

    Maternal complications: miscarriage, premature delivery, anemia, pregnancy-induced hypertension, placental abruption, heart failure, hyperthyroidism crisis, intermittent infection, type I diabetes, etc. Fetal and neonatal complications: premature babies, stillbirths, stillbirths, malformations, fetal growth restriction (FGR), small for gestational age (SGA), fetal distress, neonatal fetal rest, fetal and/or neonatal hyperthyroidism , Hypothyroidism, etc.

    Consultation before and during pregnancy It is recommended that women diagnosed with hyperthyroidism should be treated for hyperthyroidism first, and try to wait for the recovery of the disease before pregnancy.

    After listening to the doctor's analysis, Xiao Li no longer fears, and is determined to prepare for the examination and be brave to be a mother.

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