Complications during childbirth can occur in any, even a completely healthy woman. Of course, any future mother wants to give birth ideally, with minimal medical intervention, but not always everything goes so smoothly: often the process suddenly begins to go wrong, as expected. Then the help of an obstetrician-gynecologist is required. With the help of medical manipulation, doctors will send childbirth in the right direction.
The likelihood of complications increases if the woman has a chronic illness. It is important to identify pathologies as early as possible: this is why preparation for childbirth involves so many examinations and medical red tape.
What most often becomes an obstacle to the calm appearance of the baby? The most frequent complications include: weakness of labor activity, vigorous labor activity, bleeding, pathologies of preparatory prenatal period, injuries of the birth canal, and more.
Anomalies of labor – a fairly common occurrence. Especially often there is a condition when the strength, frequency and duration of contractions are insufficient for smoothing and opening the cervix, and therefore for normal delivery. The reasons are usually different physiological problems of the mother:
endocrine and metabolic pathologies (obesity, thyroid problems, diabetes);
overstretching of the uterus (in the presence of multiple fetuses, large fetus, polyhydramnios);
pathological changes in the wall of the uterus (developed after inflammatory processes, scars on the uterus after cesarean section or other surgery);
malformations of the uterus or its congenital underdevelopment;
a certain role in the occurrence of this complication may play a primipara age (younger than 18 years old or older than 30 years);
excessive neuropsychic tension (anxiety, fear of the upcoming birth, negative emotions).
There are primary and secondary generic weakness. In the primary – contractions are not active enough, ineffective and weak from the very beginning of labor. Contractions can begin well, but gradually weaken, become shorter and more frequent, without leading to the opening of the cervix. This is a secondary weakness of labor. Secondary weakness can manifest itself both in the first and in the second stage of labor. It is less common than the primary and is the result of fatigue or fear of giving birth to a woman.
The doctor makes the diagnosis individually based on the nature of contractions, the dynamics of cervical dilatation. So, if it is normal, from the beginning of regular labor to the opening of the uterine mouth, it lasts 3-4 hours on average for six hours, then with the development of the weakness of labor, this period extends to 8 hours or more. Judging by the diagnosis, a decision is made on the nature of the treatment. Distinguish between drug and non-drug methods.
Non-drug treatment is the opening of the membranes of amniotomy (amniotomy). It is carried out at the opening of the cervix 2 cm or more. For example, with polyhydramnios the muscles of the uterus are overstretched, and the opening and further rupture of water helps to reduce the volume of the uterus and the frequency of contractions. If the desired effect of amniotomy is not obtained, then the use of medication for the continuation of labor activity.
Because quite often the cause of weakness is overworking the woman in labor – a method such as drug sleep is used. This procedure involves the introduction into the woman’s body of drugs from the group of narcotic analgesics. Sleep comes quickly and lasts an average of 2 hours – a woman has time to recover the strength and energy resources of the uterus during this time.
Another medication is the use of uterotonics – drugs that enhance the contractile activity of the uterus. The main drug of this purpose is Oxytocin and prostaglandins. Oxytocin is generally safe for the fetus, but if there are any complications of pregnancy (preeclampsia, placental insufficiency), there is a threat of side effects. Arrangements for the introduction of these drugs are complex, require careful monitoring of the state of the mother and child with a heart monitor. In addition, training pains, drugs can increase the pain of a pregnant woman.
Unfortunately, all these methods of therapy successfully work only in 18-20% of cases. More often there is a need for cesarean section. Secondary generic weakness, which is not amenable to medical treatment, sometimes requires special measures – removing the child with a special apparatus, a vacuum extractor, or (quite rarely) with forceps.
If we talk about the prevention of the above described problem, then I would like to put special emphasis on nothing more than on preparing for childbirth. Physical and psychological preparation for childbirth will help prevent such problems during childbirth.
Stormy labor activity
In contrast to the weakness of labor, there is such a pathology as too rapid delivery: the duration varies from two to six hours, contractions and attempts are very frequent. It is not good.