From Big Medical Encyclopedia

FETALDESTRUCTIVE OPERATIONS — the obstetric operations made for the purpose of creation of conditions for extraction of a fruit in natural patrimonial ways when there is no conditions for performance of the operations allowing to keep life of a fruit (Cesarean section, imposing of obstetric nippers, etc.).

Also the Middle Ages were extended by the item of the lake in an extreme antiquity. Their became more rare to apply after A. Paré offered operation of obstetric version, and also after implementation in practice of obstetric nippers, antiseptics, an asepsis and anesthesia.

Islands carry out the item, as a rule, on a dead fruit. Extremely seldom it is necessary to raise a question of preservation of life of mother at the cost of the life of a fruit. Items the island are possible if the true conjugate is equal to 6,5 — 7 cm and disclosure of a uterine pharynx — not less than on 7 — 8 cm of P. islands carry out under anesthetic. Islands treat P. a craniotomy, decapitation, Evisceration and a cleidotomy.

At craniotomies (see) perforate a head of a fruit, delete a brain (excerebration), squeeze a head of a fruit and take it (cranioclasia). Decapitation (see) it is made at the started cross provision of a fruit. A decapitation hook (see. Obstetric and gynecologic tools ) separate a head of a fruit from a trunk, a pandiculation for the handle remove a trunk from a uterus, then take a head of a fruit. At the started cross provision of a fruit when it is impossible to separate a head from a trunk, make as well Evisceration (see. Embryotomy ). At the same time delete internals of a fruit after a preliminary section of its abdominal wall or a thorax. If one evisceration is not enough for extraction of a fruit, then make a spondylotomy — a section of a backbone in chest or abdominal department. For the purpose of reduction of volume of a shoulder girdle of a fruit carry out cleidotomy (see) — a section of his clavicles. The cleidotomy usually is a component of one of P. of the lake, seldom independent operative measure.

At P.'s carrying out of the lake there can be complications — disturbance of an integrity of walls of a uterus, deep colporrheses with damage of bodies of a basin, massive blood loss.

After the termination P. of the lake, the birth or removal of an afterbirth, under anesthetic make manual inspection of a cavity of the uterus and vaginal examonation by means of mirrors, compensate blood losses), and also according to indications carry out correction of vodnoelektrolitny disturbances and antibacterial therapy.

Forecast, as a rule, favorable; it worsens at women in childbirth with a heavy nephropathy, a rheumatic carditis, a diabetes mellitus and some other diseases, and also in case of complications.

Bibliography: Bodyazhina V. I. and Zhmakin K. N. Akusherstvo, page 514, M., 1979; M and x and y l of e of N to about E. T. and Bublik-D ornyak G. M. Pathological obstetrics, page 92, Kiev, 1976; The Multivolume guide to obstetrics and gynecology, under the editorship of L. S. Persianinov, t. 6, book 1, page 168, M., 1961; Practical obstetrics, under the editorship of Ya. P. Oolsky, page 611, Kiev, 1976.

V. P. Baskakov.