EMBRYOTOMY (Greek embryon a uterine fruit, a germ + tome a section, a section) — group of fetaldestructive operations, at to-rykh a fruit dismember on a part with the purpose to facilitate its extraction from patrimonial ways of the woman. It is carried out on the dead, sometimes on a live fruit in cases when there are absolute obstacles for the birth of a fruit in natural patrimonial ways and there are no conditions for performance of other obstetric operations (Cesarean section, imposing of obstetric nippers, etc.).
Carry a craniotomy to an embryotomy (see), decapitation (see), a cleidotomy (see), and also evisceration (ekzenteration) and a spondylotomy.
Evisceration is usually made at the started cross provision of a fruit when it is impossible to make decapitation, and also in case of difficulties at the birth of a trunk (a large fruit, inborn malformations of a fruit). Operation is made on condition of full opening of a uterine pharynx (an ostium of the uterus, T.) and the true conjugate is not less than 6 has some on the operating table or a rakhmanovsky bed under an inhalation anesthesia (see). External genitals, hips, abdominal wall and vagina are carefully disinfected. The Nozhnitsevidny or lanceolated perforator make an opening of the sufficient size in an abdominal wall or between edges of a fruit. Enter fingers into the received opening, and if necessary the hook, a packer or bone nippers and take interiors. First of all it is necessary to delete the largest body — a liver. Then the fruit is taken in folded form. Sometimes after evisceration in connection with difficulties of extraction of a fruit resort to spond of a lotomiya.
The spondylotomy, as a rule, is auxiliary reception at evisceration, much less often it is applied as independent intervention. The spondylotomy is made in the most available part of a backbone by means of Fenomenov or Zibold's scissors (see. Obstetric and gynecologic tools). After a section of a backbone cut with scissors soft tissues of an abdominal wall and consistently take top and bottom speak rapidly trunks of a fruit. Operation can also be made by means of Kyustner's rachitome. At the same time the internal acute spoon directed by an edge to a backbone of a fruit is put on a tummy; the outside spoon is placed on a backbone. After a smykaniye of spoons of a rachitome the backbone of a fruit is cut in half. If a coat hanger of a fruit is an obstacle for extraction of a trunk, previously makes a cleidotomy.
During the performance of operation perforation of a uterus, an injury of soft patrimonial ways are possible; in a puerperal period development of infectious complications is possible. After operation make manual department and allocation of an afterbirth for early detection of a hysterorrhesis, inspect walls of a uterus, examine a neck of uterus by means of mirrors.
The forecast for the woman at the correct carrying out operation, as a rule, favorable.
See also Fetaldestructive operations.
Bibliography: Bodyazhina V. I. and
Zhmakin K. N. Akusherstvo, M., 1979; I. F Zhordania. Textbook of obstetrics, M., 1964; Malinovsky M. S., Operational obstetrics, M., 1974.
L. P. Bakuleva.