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We give birth to the third...

Possible problems of mothers having many children

will be solved On the birth of the third child not each woman. On the one hand, it is essential load of an organism, with another - the next crisis moment in family life. To the woman, as a rule, being already financially secure and professionally taken place, it is possible to take out the child without excessive fears and vanity. The third pregnancy gives the chance to listen to the feelings, to understand them and to take necessary measures at any adverse symptoms. Frequent pregnancy the woman planned, so, prepares for this event beforehand. The organism becomes more senior, “wiser“, and pregnancy proceeds on already known, blazed, to ways.

However repeated pregnancy, childbirth and the postnatal period differ in some features about which we also will talk.

the Course of pregnancy

the Third pregnancy proceeds usually favorably, without the sharp toxicoses characteristic of the first pregnancies (it is the general tendency, but the organism of each woman, of course, is individual).

Chronic diseases . After 35 years there are first symptoms of chronic diseases that can be the fact aggravating for the course of pregnancy. Frequency as genital (chronic salpingooforit, endomiometrit, uterus myoma, endometriosis), and ekstragenitalny pathology increases (chronic diseases of respiratory organs, urinary tract, it is warm - vascular system and endocrine systems). In this case the probability of development of late toxicosis of pregnancy and progressing of such diseases as pyelonephritis, a hypertensive illness, diabetes increases. All this demands inspection and treatment. If the age of mother exceeds 35 years, and the father - 45 years, the probability of malformations of a fruit increases. To exclude this diagnosis, it is possible to address in genetic consultation.

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Besides, during repeated pregnancies the woman is more subject to development and progressing of such states as anemia and a varicosity that is connected with increase in physical activity at an organism and “wear“ of its reserve forces.

Varicosity . In 70 - 90% of cases the disease develops in pregnancy time. The first symptoms of a varicosity - emergence of a vascular setochka standing, the puffiness increasing by the evening. It occurs from - for the fact that during pregnancy the volume of the circulating blood increases by 30 - 50%. The possibility of venous vessels to maintain the increasing loading is limited, the blood-groove in the lower extremities is slowed down. The situation is especially aggravated with presence of excess weight, endocrine diseases, hereditary predisposition, violation of rheological properties of blood (coagulability increase). Walls of vessels “are tired“ of tension and relax, stretching characteristic bluish waves under skin. The situation can progress, involving in process vessels not only legs, but also external sexual and internals. For example, gemorroidalny knots - no other than the restretched walls of venous vessels of the lower department of a rectum which are sharply increasing at increase of pressure in an abdominal cavity and a small pelvis - for example, at a natuzhivaniye. As prevention of a varicosity compression stockings which help veins to cope with the raised loading, the raised position of legs during a dream, special gymnastics and observance of the diet directed to prevention of locks are recommended. As treatment - the preparations improving the microcirculation and rheological properties of blood (i.e. the preparations diluting blood) strengthening a vascular wall, raising its tone.

the probability of progressing of a varicosity is Especially high

when the first symptoms of varicosity appeared even during the previous pregnancies.

Anemia - decrease in amount of hemoglobin in red blood cages - erythrocytes. During repeated pregnancies of the woman get more often to risk group on development of iron deficiency anemia which is observed at every fourth woman. Low level of hemoglobin in blood results in oxygen insufficiency of a placenta, and the reserves necessary for development of the child are lowered. Such states as slackness, weakness, dizziness, sight violation, heartbeat, short wind, memory impairment and attention can also be a consequence of anemia. Therefore in this case control of the level of hemoglobin and content of iron in blood is recommended. Prevention of this state is promoted by healthy nutrition. To all pregnant women, and especially povtornorodyashchy women, recommend to accept ferriferous preparations a course not less than 4 - 6 weeks 2 - 3 times during pregnancy.

of Pererastyazheniye of muscles of a forward belly wall . Physiologically from - for reprolixity of a forward belly wall the center of gravity is displaced forward more, than during the previous pregnancies. In addition, the fruit during repeated pregnancies, as a rule, weighs more, than during previous, and the woman is stronger, than in the first pregnancy, feels weight or even waist pain and a sacrum, in the bottom of a stomach. In process of growth of a uterus the stomach deviates kpered more and more, kompensatorno increasing a bend in lumbar department of a backbone. In this case it is possible to recommend carrying a bandage which, supporting a stomach from below, somewhat restores balance and reduces loading on poyasnichno - sacral department of a backbone (when future mother lies, the bandage is not required to her).

the Bandage should put on

lying. For prevention of weakness of muscles of a forward belly wall it is recommended to carry out special exercises if for this purpose there are no contraindications. It is, for example, about the exercises strengthening oblique muscles of a stomach is the some kind of natural “bandage“ supporting will shade a uterus. Fitness of these muscles weakens load of lumbar department of a backbone, prevents emergence of extensions on a forward belly wall. Standing on the left leg and leaning against something, you get the right leg for left alternately in front and behind. Then change a supporting leg.

Insolvency of muscles of a pelvic bottom, weakness of the copular device from - for stretchings or ruptures of muscles and a linking of a pelvic bottom during the previous childbirth can be shown by

in the form of dribble of urine at a tension - laughter, cough. The urine incontience during pregnancy is observed at the multigiving birth women (approximately at 13%) more often than at pervorodyashchy.

Low arrangement of a placenta . One of obstetric adverse situations is the low arrangement of a placenta or its prelying when the placenta in whole or in part blocks an internal pharynx of a neck of a uterus - an exit from a uterus. “Wear“ of a mucous uterus the previous childbirth or abortions can be the cause. This state is often shown by bleedings already during pregnancy. However in process of growth of a uterus during pregnancy the placenta can be displaced, migrate, rising up, and bleedings stop. The woman should be very attentive to the feelings and the appearing symptoms.

Insolvency of muscles of a pelvic bottom . The raised load of a pelvic bottom during pregnancy and especially - in the second period of childbirth can lead to omission of walls of a vagina, emergence of gemorroidalny knots, an incontience of urine both during pregnancy, and in the postnatal period that at repeated childbirth occurs more often. After the delivery the copular device of genitals and muscles of a pelvic bottom will be stretched, the uterus is very mobile and is easily displaced. Muscles of a pelvic bottom are relaxed and are not able to hold a uterus in physiological situation that often leads to omission of internals after the delivery.

the Rhesus factor - the conflict . With each new pregnancy the risk of development a Rhesus factor - the conflict increases. After the first pregnancy a Rhesus factor - antibodies appear approximately at 10% of women, after everyone the subsequent - approximately at so many.

the Rhesus factor - the conflict is possible at women about a Rhesus factor - negative blood at a Rhesus factor - positive blood of a fruit. Erythrocytes of a fruit can get to mother`s blood already with 6 - 8 - y weeks of pregnancy. And if in the previous pregnancies a Rhesus factor - a positive fruit even a small amount a Rhesus factor - positive erythrocytes got to mother`s blood-groove, then at repeated pregnancy (especially if except childbirth there were also abortions) the quantity of antibodies in blood of mother can reach the threshold size at which fruit erythrocytes will begin to collapse. As a result of fruit blood penetration with positive a Rhesus factor - erythrocytes in mother`s blood-groove in her organism antibodies - protective proteins which, in turn, through a placenta get to a fruit begin to be developed. In its organism there is a reaction “an anti-gene - an antibody“ which leads to destruction of erythrocytes of a fruit - to a gemoliz. This state is called “hemolytic illness of a fruit“ (HIF); externally it is shown as jaundice.

can lead

of GBP to adverse effects for health and even life of a fruit or the newborn. At the same time to the newborn (according to indications, depending on severity of his state) zamenny blood transfusion is made: to restore the destroyed erythrocytes, to the child pour a Rhesus factor - negative blood of the first group. In the absence of antibodies during previous and the woman given pregnancies it is necessary to enter after the delivery no later than 72 hours an anti-Rhesus factor - the immunoglobulin preventing formation of new antibodies (it is better to make it within the first days). It also is prevention a Rhesus factor - the conflict at the subsequent pregnancies. It is recommended to trace a condition of blood on an anti-Rhesus factor - antibodies and especially - change of their quantity. At increase of quantity of antibodies need for an early rodorazresheniye can appear.

Perenashivany pregnancies . It is known that each subsequent child is larger than previous. Statistically, the second child is 20 - 30% larger than the first. It is possible to assume that it is defined by several factors. One of them - psychological, that is, bearing the second kid, future mother is quieter as she is already not by hearsay familiar with pregnancy and childbirth. The fact that during the second pregnancy the organism of mother is already trained in incubation of the kid can be one more cause, blood circulation in matochno - placentary and plodovo - placentary vessels provides bigger intake of nutrients to a fruit, than during the first pregnancy. This fact creates prerequisites for a pregnancy perenashivaniye as from - for reprolixity of a uterine wall receptors become not so sensitive to hormones which, influencing a uterus, start its reduction, and the beginning of childbirth drags on. In this case it is important to watch a functional condition of a fruit; for this purpose at the end of pregnancy it is necessary to visit the doctor at least 1 - 2 time a week. At emergence of the first signs of a perenashivaniye (reduction of amount of amniotic waters, decrease in physical activity of a fruit, etc.) the doctor will offer the woman hospitalization. In these situations especially actually in due time to carry out such additional methods of research as ultrasonography, a doppler (research of a blood-groove in vessels of a fruit, umbilical cord), by KTG (registration of warm reductions of a fruit).

Childbirth

the Third childbirth in general takes place

quicker, the period of formation of a lactation since the dairy courses “are already open“ proceeds easier. At the expense of good tensile properties of tissues of crotch at repeated childbirth patrimonial traumatism considerably decreases, in particular the quantity of injuries of crotch decreases.

At the same time at repeated childbirth such complications as fast childbirth, postnatal bleedings, an exacerbation of various chronic diseases, etc.

are possible

Fast childbirth . Easier disclosure of a uterine pharynx, more rapid current of patrimonial process in general is characteristic of the third childbirth, i.e. transient (till 4 o`clock) childbirth can find the woman at work, on the street, in transport. Repeated childbirth proceeds quicker than the first due to faster opening of a neck of a uterus (a uterine pharynx).

Secondary weakness of patrimonial activity . From features of a course of the third childbirth the high frequency of violations of a patrimonial rhythm in the form of secondary weakness of patrimonial activity attracts attention (in this case patrimonial process at first goes actively, and then its speed, instead of increase, begins to decrease). Such situation can demand urgent purpose of medicines. The second period of childbirth can be complicated by secondary weakness of patrimonial activity from - for restretchings of a forward belly wall, is frequent - from - for the expressed development hypodermically - fatty cellulose or at a large fruit.

some complications and in the third period of childbirth when the placenta separates Are possible

. So, from - for the lowered tone of walls of a uterus there can be difficulties at office of an afterbirth, from - for existence in the past in a wall of a uterus of inflammatory processes the placenta can be attached or separate densely not completely. All these states demand manual inspection of a uterus.

Postnatal period

Bleeding . During the postnatal period the probability of bleeding due to decrease in sokratitelny ability of a uterus increases. Problems with office of a placenta in the third period of childbirth are for the same reason possible. The better the uterus is reduced, the risk of pathological bleeding at which the volume of blood loss exceeds 0,5% of body weight of the woman is less. After office of a placenta the internal surface of a uterus which is plentifully supplied with vessels opens and there is a real risk of fast loss of a large amount of blood. At reduction of a muscle of a uterus vessels contract, promoting formation of the blood clots closing them therefore bleeding decreases, and then stops absolutely. In case of violation of sokratitelny ability the uterus remains sluggish and vessels continue to bleed plentifully. From - for dangers of bleeding in the early postnatal period doctors - obstetricians pay the closest attention to the multigiving birth women.

the Tendency to hypotonia (slackness) of a uterus remains and further - during the late postnatal period that can lead to a delay in a cavity of a uterus of postnatal allocations. On this background inflammatory processes of an internal cover of a uterus (endomiometrita) can develop. Therefore to the multigiving birth mothers during the postnatal period usually appoint the reducing means, and before an extract conduct control ultrasonic research.

Prevention of these unpleasant states which can demand physiotherapeutic influence, for example, of a miostimulyation (physiotherapeutic procedure during which there is an impact on different groups of muscles promoting their training), and even surgical intervention, are exercises for a crotch - the known exercises of Kegel in different modifications. Any muscles without training will atrophy. And considering the forthcoming loading, training of these muscles is simply necessary. It is possible to begin occupations after 16 - 18 weeks of pregnancy, actively continuing to carry out them and during the postnatal period.

It is unconditional, the third childbirth - hard test. But the knowledge of features of repeated pregnancy and childbirth, and also the previous experience of incubation and the birth of the kid will allow the woman to pass surely process of childbirth and to be restored quickly during the postnatal period.