Fetal colon dilatation

Many parents actually don’t know what colon dilatation is. In fact, for infants, this condition may be caused by intestinal obstruction. Generally speaking, fetal intestinal obstruction can only be seen during B-ultrasound examination, so when the baby shows some abnormal behavior, parents should take the child to the hospital for examination in time to avoid intestinal obstruction.

Some intestinal dilatation is due to congenital intestinal malformations, while some is just transient intestinal obstruction of the fetus caused by meconium blockage or other reasons. Such intestinal dilatation can heal itself. The results of color ultrasound can only be an effective method to diagnose fetal intestinal dilatation, but intestinal dilatation cannot be confirmed as intestinal malformations and is not an indication for induced labor.

The key is to know the range of fetal intestinal dilation, how many mm? Is it continuing to expand?

If there is obvious fetal intestinal dilatation (diameter of dilated intestinal loop ＞30mm) or a clear diagnosis of digestive system malformation is made before delivery, induced labor and abandonment of the fetus can be chosen.

If the fetal intestinal dilatation is within the normal range, there is no obvious fetal intestinal dilatation, and there is no continued dilatation, the fetus is not seriously affected and you can choose to continue the pregnancy.

However, special attention should be paid: pregnant women should be closely monitored and checked regularly, and after delivery, the neonate should undergo abdominal X-rays and barium enema examinations to check for obstruction and determine the type of obstruction. Umbilical cord blood was collected at delivery for fetal chromosome karyotype analysis.

1. Abdominal external examination: At the end of pregnancy or the beginning of labor, abdominal examination will show that the fundus of the uterus is horizontally wide and lower than that of the corresponding gestational age. The uterus has lost its normal oval shape and becomes horizontally wide and flat. The fetal head is located on one side of the lower abdomen. The fetal head or buttocks cannot be felt at the fundus of the uterus, but the concave fetal abdomen and fetal limbs can sometimes be felt. In the lower abdomen, you can feel the fetal head and buttocks on each side. The lower part of the uterus is empty and the fetus cannot be felt. There is nothing above the pubic symphysis. If the fetus is in anterior position, the back of the fetus is forward in the lower abdomen, and the hard, wide flat surface of the back can be felt. If the fetus is in posterior position, the back of the fetus is backward, and small limbs can be felt in the abdomen. The fetal heart rate may be clearest on the left or right side of the navel.

2. Vaginal examination: If labor has begun, the cervix is ​​relaxed, the presenting part is high and floats above the pelvic entrance, and there is a feeling of emptiness in the vaginal vault. If the labor has progressed to the point where the membranes have ruptured, irregular lumps may sometimes be felt. If the labor has progressed for a long time, the fetal acromion, scapula, ribs and axilla may often be felt in the cervical os, and sometimes a row of ribs may be felt. By inserting your fingers into the uterine cavity, you can feel the armpit and shoulder blade. The tip of the armpit points to the fetal head. The fetal position is determined by whether the shoulder blade is forward or backward. The shoulder is on the left or right side of the mother's body. If the left shoulder is anterior, the tip of the armpit points to the left and the shoulder blade is in front. Clinically, the condition is characterized by neglected transverse position, and vaginal examination should be performed immediately to confirm the diagnosis.

During vaginal examination, if it is a small limb, the doctor should distinguish between the hand or foot, elbow or knee, shoulder or buttocks. If the fetal hand is prolapsed in the vagina, it should be identified as a hand. The fingers are long and uneven, the fingers are easy to open, and the thumb can be bent to touch the base of the little finger. If the fetal hand is prolapsed out of the vagina, the examiner should shake hands to distinguish whether it is the left hand or the right hand. The doctor holds the prolapsed right hand with his right hand. Generally, the right hand is prolapsed in the front left, and the left hand is prolapsed behind the left shoulder. If it is the right shoulder, then in the opposite direction if it is the foot, the toes are short and even, with a small degree of spread, and it is not easy for the two ends of the toes to be brought together. You can even feel the heel and it is vertically connected to the leg, which is easy to identify.