The problem of abnormal contracting of the uterus during childbirth always remains one of the cardinal problems in obstetrics, since the prevention of this pathology contributes to the reduction of perinatal mortality and the occurrence of serious complications in the mother's body.
The main criterion for the course of labor is:.
characteristic of the fights themselves (regular, sufficiently strong, painful) dynamics of opening of the uterine throat, in primiparous uterus opening 1 cm per hour, in re-giving 2 cm per hour.
Head movement through the birth canal Classification of abnormalities of labor.
Pathological preliminaries.
The weakness of the labor activity is primary (the woman enters into labor with the weakness of labor that lasts throughout all births) secondary (after the period of active labor the uterus condones) Excessive labor activity.
Discoordinated labor activity.
General discoordination of the hypertonus of the lower segment of the tetanus of the uterus (total increased uterine tone) circular histology of the cervix Treatment of abnormalities of labor activity Determined by the condition of the woman. When the mother is fatigued, she should be given rest for 2-4 hours (obstetric anesthesia). After the end of narcotic sleep, the labor activity is usually strengthened and additional use of the means stimulating labor is not required. If the contractions remain weak, one of the pharmacological schemes of rhythmostimulation. Caesarean section with weakness of labor should be used only in those cases when conservative therapy is unsuccessful and the prognosis of labor for the mother and the skin is unfavorable, especially when combined with the weakness of labor activity with another pathology (pelvic presentation of the fetus, weighed midwifery history,. With secondary weakness of labor activity that is not amenable to drug therapy, depending on the obstetric situation, obstetrical forceps are applied, vacuum extraction of the fetus, removal of the fetus from the pelvic end, etc.. In case of weakness of attempts in connection with the incompetence of the muscles of the abdominal press, Verbov bandage is sometimes used - a special device made of tissue to tighten the abortion of the parturient woman during the attempt. Bint Verbova can be replaced with a sheet. In cases of rigidity of the uterine throat and the unsuccessful use of antispasmodic agents, it is sometimes resorted to its digital extension. If there are signs of developing infection, as well as anhydrous interval more than 10 hours, if the end of labor is not expected within the next 1-2 hours, antibiotics are prescribed.
With excessively strong, labor, delivery is aimed at reducing labor activity. The mother is laid on her side, opposite the position of the fetus, and is given anesthesia. Childbirth takes in the position of a woman on her side, opposite the position of the fetus.
In the case of non-coordinated labor, psychotherapy, analgesic, sedative, spasmolytic, P-adrenomimetic drugs, obstetric anesthesia. Effective electroanalysis. In the case of development of convulsive fights, or tetany of the uterus, treatment depends on the cause of this complication. If the birth canal is prepared, then under anesthesia, the fetus is extracted with the help of obstetric forceps (with the head preposition) or with the leg (with breech presentation). When a dead fruit is produced a fruit-destroying operation. After the extraction of the fetus, manual removal of the placenta, separation of the placenta and examination of the uterine cavity are carried out to avoid ruptures.
Prevention of abnormalities of labor The purpose of prevention of abnormalities of labor is to carefully observe the treatment and protection regime, careful and painless management of labor. Medication prophylaxis is carried out in the presence of risk factors for the development of abnormalities in the contractile activity of the uterus: young and elderly age of the primiparas; aggravated obstetric-gynecological history; indication of a chronic infection; presence of somatic, neuroendocrine and psychoneurological diseases, vegetative-vascular disorders, structural infertility of the uterus;
fetoplacental insufficiency; overgrowth of the uterus due to polyhydramnios, multiple fetuses or large fetuses.
Women who are at risk of developing abnormal labor should be physically assisted in the preparation for childbirth, teach methods of muscle relaxation, control of muscle tone, skills to reduce increased excitability. Night sleep should be 8-10 hours, daily rest at least 2-3 hours. Provide for a long stay in the open air, rational nutrition.
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