METREYRIZ (metreurysis; grech, a uterus + euryno to expand, move apart metra) — obstetric operation of introduction to a cavity of the pregnant woman uterus cervical dilator — the rubber bulb intended for disclosure of a neck of uterus and stimulation of patrimonial forces. This operation is applied by modern obstetricians extremely seldom.
The cervical dilator was for the first time offered by D. M. Trubnitsky in 1853. There are different models of cervical dilators; in the USSR almost only use a pear-shaped cervical dilator. They can have volume from 150 to 350 ml (for abortion in late terms) from 400 to 500 ml (are applied at the cross provision of a fruit, amotio of the prelying placenta). The cylinder is entered or into a cavity of a bag of waters (vnutriobolochno), or out of it (vneobolochno). It makes pressure upon an isthmus of a uterus, reflex causes its reductions, replaces the prelying part of a fruit.
Indications and Contraindications
Indications: abortion according to medical indications in time over 18 weeks (the cervical dilator is entered vneobolochno) to cause or strengthen pains impact on receptors of the lower segment; bleeding at incomplete placental presentation (enter a cylinder vnutriobolochno) with the purpose to drive into the corner a uterus the exfoliating placenta.
Contraindications: severe forms of a nephropathy, an eclampsia, new growths in a neck of uterus, existence of inflammatory process in a parturient canal; hems of a pas to a uterus after the postponed Cesarean section or a myomectomy.
The woman in labor is placed on ginekol, the chair also is processed by external genitals. Before introduction the cylinder is curtailed and taken a curved packer (fig. 1).
The neck of uterus is bared mirrors, front and back her lips are fixed bullet nippers. If necessary the neck of uterus is expanded with Hegar's dilators to No. 17 — 20. The cervical dilator is carried out via the channel of a neck of uterus for an internal pharynx (fig. 2) and filled by means of a Janet's syringe with sterile isotonic solution of sodium chloride. After filling of a cylinder the packer is carefully removed, and on a tube of a cylinder impose a clip (fig. 3); then remove bullet nippers and take a vaginal speculum. For strengthening of action of a cervical dilator to its tube it is possible to suspend a load (200 — 300 g) via the block. The cervical dilator shall not be in a cavity of the uterus over 6 hours in order to avoid development of the ascending infection.
Injuries of a neck of uterus at careless introduction of a cervical dilator, the premature placental detachment caused by introduction of a cylinder, infection of a genital tract. In case of the specified complications surgery and antiinflammatory therapy is shown.
Bibliography: Baksheek N. S. Uterine bleedings in obstetrics, Page 201, Kiev, 1975; B about d I and N and V. I. and m of joint stock company and K. N. Akusherstvo's N, page 472, M., 1979; Malinovsky M. S. Operational obstetrics, page 363, M., 1974; The Multivolume guide to obstetrics and gynecology, under the editorship of L. S. Persianinov, t. 6, book 1, page 48, 97, M., 1961; Starovoytov I. M. Metreyriz in obstetric practice, Minsk, 1959.
G. A. Palladi.