Induction of labor - when the body refuses to work
October 16, 2008
Childbirth - one of the most important moments in the life of a woman. Some women prefer to trust completely in the matter doctor, while others, on the contrary, want to know how and what they will do. Probably, and they are right, and others, because it all depends on the character. That less, it is better to know exactly which method of management of labor you have to offer.
The normal duration of labor
Even the ancients noticed that the more long-term births occur, the less chance of having a healthy baby. Then it has been identified and normal delivery dates - no more than a day since the start of contractions. In our time, the normal duration of labor is considered to be 18 hours for nulliparous and 12 multiparous hours. In practice, normal deliveries are continuing up to 10 hours - longer contributes to the birth trauma and infection for both mother and child.
Why are protracted birth
It so happens that the contractions started, become rare and unproductive, then talk about the weakness of labor. This condition may occur at different metabolic and endocrine disorders (obesity, thyroid disease
Thyroid disease - women at risk
Diabetes mellitus), pelvic inflammatory disease, very young or, on the contrary, the women later in life, with hyperextension of the muscles of the uterus due to the polyhydramnios or large fetus, twins, etc. Sometimes also a genetic predisposition to the weakness of labor.
With the weakness of labor is reduced allocation of oxytocin (a hormone that stimulates contractions of the uterus).
In some cases, a rodostimulyatsiya
The weakness of labor activity may be primary (rare weak contractions from the start) and the secondary (first normal contractions weaken during childbirth).
- if during childbirth occurred weakness and weak labor contractions do not allow the cervix to open up to 2-3 cm after six hours in nulliparous and three hours multiparous (primary weakness of labor);
- if during the first normal childbirth contractions become weak and irregular, the cervix does not open for a long time (secondary weakness of labor).
- if during childbirth water broke and no regular contractions for a few hours;
- If the uterus is too stretched due to polyhydramnios, large baby or twins;
- if a woman is tired and completely exhausted from labor.
Rodostimulyatsiya not carried out if:
- the size of the fetal head does not match the size of the pelvis mothers;
- Pulse on signs of fetal hypoxia (lack of oxygen);
- fruit correctly positioned in the uterus;
- the mother has a scar on the uterus after cesarean section;
- if the mother has high blood pressure
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How to restore normal delivery activities
If you do not water broke, the doctor opens the bag of waters (amniotomy) - it speeds up the fight. The cervical canal introduced a special gel that prepares the cervix for childbirth, shorten it, and soften. This happens due to the substances contained in the gel - prostaglandins.
Restore normal delivery activities using drugs (oxytocin polusentitichesky devoid of side effects, and more modern drugs - enzaprost, sorry). Oxytocin stimulates contraction of muscle fibers, but does not affect the state of the cervix, so enhances pain. In order to relax the cervix and relieve pain, antispasmodics are introduced (eg, no-silos).
Despite the fact that obstetricians now have quality medicines for induction of labor, such a preparation that would reproduce natural contractions desired strength and duration not. Therefore rodostimulyatsiya - this, of course, the risk to the child, but it is still not as traumatic for him than the process of prolonged labor.
Rodostimulyatsiya performed with anesthesia and controlled by the state of the fetus (there is a special device - a heart monitor). In order to prevent deficiency of oxygen entering into the baby's brain (fetal hypoxia), various medications administered. Stimulant drugs are administered intravenously, picking each woman individually (minimum) dose and the speed of the input. Doctors are trying to achieve the result, in which there is a struggle in 3-5 minutes, no more. Prolonged administration of such formulations should not exceed 4-5 hours. If rodostimulyatsiya fails during this time, it is stopped and caesarean section.
Prevention weakness of labor
For the prevention of the weakness of labor should promptly eliminate all diseases that could cause it. Therefore, prior to conception
Conception, ovarian cycle, fertilization and genetics of a child
or in early pregnancy obligatory medical consultation. At the same time it is better to lose weight and lead a more sedentary life. By the weakness of labor can also cause eating disorders, sleep
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and the rest of the pregnant woman.
Severe birth: as it happens
December 9, 2010
All pregnant women are afraid of what they will be hard labor, and they will not be able to cope suddenly die or baby mother herself. In fact, it is very difficult birth are rare, and doctors are trying to predict complications during caesarean section. Every obstetrician-gynecologist have in mind particularly difficult birth that he had ever taken, and about which not very much and want to remember.
The concept of "hard labor"
Severe birth are called births that occur with complications, and on the severity of these complications depends on the severity. This may be bleeding, Foot presentation, fetal asphyxia, the use of forceps and other. And there are equally difficult birth as in nulliparous and multiparous. According to the rules, heavy labor has to take himself obstetrician and midwife just helps. It is known that birth include three periods and complications can occur at any stage of labor. But the most difficult birth, perhaps, are those complications which occurred during the second period (the period of the expulsion of the fetus). It was during this period to carry out a caesarean section does not make sense (and no time), as a danger to the child's life is maximized. Most often in the second period it is difficult to predict the behavior of the mother, and how to influence it.
Example One - Foot previa
It is known that foot presentation - one of the worst options for presentation. This is due to the fact that considerably fewer legs the baby's head, namely the head of the fetus during labor passes through the birth canal, widening them and allowing problem-free birth of the entire body of the child. Therefore, at this time, foot previa is mandatory indications for cesarean section. But you can not always have time to do the surgery.
The new mother enters the hospital 45 years
. From history: third generations, the interval between the previous and present birth more than 20 years, a host of related extragenital diseases associated with age and, most importantly, gestational age 34 weeks
. On examination: uterine mouth opening fully (10 centimeters), the fetal bladder is absent (which, of course, is bad, because the legs have nothing to hold), and finally, foot previa
. What to do in such a situation, the doctor? Bathe, change clothes and to get to the generic table, holding back (if possible) legs had to be born at least pelvic end (buttocks)
. But, man, in this case - a doctor, proposes and God disposes
. Therefore, in this example, the legs had fallen out, and delivery stalled
. Of course, there is a maternity reception-Maurice-Levre LaChapelle when the child should be put at the top of the hand, finger stick it in her mouth, bending the head, and in a position to pull it
. But all this is just only in a book on picture
. In fact, the case may be delayed and it is not known how the child dies
. In this case, the time took about ten minutes
. By all rights, the child has to die, it is necessary to get at least the dead, otherwise operation can not be avoided plodorazrushayuschey
. After the birth of a child and looked like a dead ... But, thanks to the efforts of its resuscitation and prematurity - the kid survived
. End of story turned out to be fortunate
. Although hypoxia-tested in live births and the child is not behind in the physical and mental development
Second example - Foot previa
The woman in labor enters the emergency room complaining of attempts
. A woman, if I may say so, only 18 years old, the first birth, 32 weeks of gestational age, registered on the pregnancy was, ultrasound does not pass, the analyzes did not hand over
. On examination, it turns out that the child is not one (double), complete opening of the uterine mouth and foot operated the first presentation of the fetus
. A woman makes an effort in full, it is placed at the family table, and an obstetrician is preparing for the worst (the first birth, the birth canal is not ready, a double, plus Foot previa)
. The behavior of mothers during attempts inadequate: it is trying to run away from the table, closes hands crotch, waving his legs and hit a doctor in the stomach ... The case itself is heavy, but there is also a riot of mothers, which in every way hinder the already difficult childbirth
. After (finally) the birth of the first child, which is in asphyxia, it is found that the second is in the scabbard previa
. Bearing-down period on average lasted thirty minutes, during which time affected not only newborns, but also the doctor
. In this case, the end is also favorable - children revived, and later they made up for their weight (premature birth), and did not experience mental retardation