Rus Articles Journal

In the conditions of deficiency. What is ``lack of water``?

Unfortunately, not always pregnancy proceed without complications. In certain cases for safety of mother and the kid offer the woman hospitalization in maternity hospital, in office of pathology. What can become a reason for treatment in a hospital?

the Diagnosis “lack of water“ usually causes concern in future mothers. What is this state dangerous to the kid by as it can affect the course of childbirth and whether it is possible to fight against it?

“Habitat“

During all pregnancy the vital space of the kid is limited by a uterus cavity. Besides the fruit, in a uterus there are fetal covers and a placenta - so-called bodies of pregnancy. These bodies really appear and function in an organism of future mother only during pregnancy; after birth of the kid they separate from a wall of a uterus and are born in the form of an afterbirth.

the Main function of fetal covers is creation and maintenance of normal conditions for pre-natal life of the kid. The considerable role in providing an optimum microclimate for a fruit belongs to an amnion.

Amnion, or the water cover, represents the closed bag in which there is a fruit surrounded with waters. The water cover densely adjoins to an internal surface of a wall of a uterus, covers an internal surface of a placenta and passes to an umbilical cord, covering it in the form of a case. Into areas a pupochka of the kid the cover passes to tummy skin, gradually merging with it.

the Foetal bubble (amnion) consists of a thin membrane in which distinguish two layers. The inside layer - epitelialny - is turned to a fruit. The external layer is called soyedinitelnotkanny and closely adjoins a uterus wall. Fetal bubble thin, but dense and very elastic. Its surface transparent, smooth and a little brilliant.

of the Wall of a fetal bubble during pregnancy produce special liquid - amniotic waters. Normal the amount of waters by the end of pregnancy makes from 800 to 1500 ml. The structure amniotic, or amniotic, waters includes protein, various salts, urea, carbohydrates (sugar) and hormones (follikulin, gonadotropny hormone), necessary for a normal metabolism and development of a fruit. In the first half of pregnancy fetal waters transparent and pure. In the second half, and especially by the end of pregnancy, water grow turbid a little. This turbidity depends on the fruit elements which are added to amniotic waters. Treat these elements:

the Composition of amniotic waters is controlled by walls of a fetal bubble: the fetal bubble is penetrated by the thinnest blood sosudika which of plasma are formed fetal, waters. Amniotic waters are constantly updated; full change of composition of waters normal happens approximately for three days.

Physiological value of amniotic waters in development of pregnancy and a fruit hugely.

the Amount of amniotic waters with the course of pregnancy gradually increases. In the first months of waters rather there is a lot of, and the kid can freely move, “swim“ in the water receptacle. By the end of pregnancy the amount of waters increases, stretching uterus walls, but at the same time the fruit considerably grows, and it grows quickly enough. In the third trimester the fruit occupies already almost all cavity of a uterus, movements of the kid are limited: it cannot as earlier, constantly to change a pose and situation in a uterus.

Physiological value of amniotic waters in development of pregnancy and a fruit hugely. Waters create unique habitat for the kid. They interfere with formation of unions between amniony and fruit skin. Amniotic waters create an opportunity for free active movements of the kid, so necessary for his correct, normal development. Along with it waters protect an umbilical cord and a placenta from pressure from large parts of a body of a fruit. Amnion and amniotic waters protect the kid from pushes and bruises from the outside, do the movements of the kid by less notable for future mother, the normal amount of amniotic waters provides formation of the correct provision of a fruit in a uterus by the end of pregnancy. The fetal bubble filled with waters participates in the course of disclosure of a neck of a uterus in the first period of childbirth: during fight of a wall of a uterus contract, forcing an elastic fetal bubble “to vybukhat“ in a uterus neck gleam; pressure of a fetal bubble upon a neck of a uterus increases its disclosure.

And, leaves, without water... As it was already told by

to h2, the normal amount of amniotic waters at the full-term pregnancy fluctuates from 800 to 1500 ml. A situation at which amount of waters “falls short“ to the lower bound of norm, in obstetrics it is accepted to designate as lack of water.

are various

of the Reason of insufficient amount of amniotic waters. Practically always various pathologies of fetal covers are the main reason for lack of water (an amnion, or a fetal bubble). It is not surprising: amnion it is responsible for production and an exchange of fetal liquid. Let`s list the most widespread factors influencing reduction of amount of waters:

  • of Infection of fetal covers - most often viruses are the reason of infectious defeat of an amnion (a SARS, flu, so-called “children`s infections“: chicken pox, measles, etc.) they are capable to get through a placentary barrier. Less often infectious agents get on fetal covers in the ascending way - from a vagina. Introduction of the infectious agent in a fetal cover, the poisoning action of products of its activity (toxins) exerts the damaging impact on amnion, breaking its main properties and functions. As a result fetal covers lose elasticity and resistance to gaps, are stratified, gain the increased permeability. In certain cases, on the contrary, fetal covers become too dense, lose transparency. Anyway practically always as a result of infection of an amnion one of its major functions - an exchange and production of fetal waters suffers.
  • of Anomaly of development of fetal covers - an underdevelopment of an amnion, stratification of leaves of fetal covers, insufficient sekretorny activity epitelialny (making a mucous membrane) the cages of a fetal bubble responsible for production of waters. The adverse factors of environment influencing future mother during formation of covers (the first trimester of pregnancy) genetic disorders (a hereditary factor) can be the cause of development of any of these anomalies, etc.
  • of Amnionalnaya the hydroyard - so is called dribble of amniotic waters from a uterus cavity during pregnancy. There is this state in connection with emergence of a small high rupture of covers. The reasons of formation of such defect of covers are up to the end not studied; it is supposed that covers become thinner owing to virus defeat or defect of a structure of a wall of a bubble. The crack which is formed at the same time between a cover and a wall of a uterus is so narrow that only a minute quantity of waters passes. In this case waters gradually, on drops expire from a uterus.
    If future mother lies in a bed and observes absolute rest, pregnancy can continue as functioning amnion gradually fills the lost waters.
  • the True perenashivaniye of pregnancy - the main sign of a perenashivaniye are gradual decrease in functional activity of fetal covers and a placenta that, in turn, is reflected in deterioration in the general condition of a fruit. By Malovodiye at a perenashivaniye it is connected with aging of amniotic covers and placentae, violation in them of blood circulation and consequently - and reduction of production of fetal waters.
to
At increase of symptoms and confirmation of the expressed lack of water needs treatment in a hospital.
Malovodiye`s

during pregnancy it is fraught with development of various complications. In certain cases so it is not enough waters that uterus walls, densely adjoining a fetal bag, strongly bend a fruit and bring it into long and close contact with a fetal bubble. As a result a number of complications can develop: a backbone curvature, a clubfoot, an union of integuments of a fruit with amniony. From a lack of waters skin of the kid becomes dry and wrinkled. At close and long contact of an amniotic cover with fruit skin between them so-called simonartova of a sheaf - quite strong tyazh and threads can be formed. They can twist a fruit, significantly limiting its activity, and sometimes and causing it heavy mutilations (an union of bodies of a fruit with each other, with covers, defects of formation of extremities, persons, etc.) . The same sheaves can press an umbilical cord, breaking a blood-groove in funic vessels. The last can lead to a delay of physical development (owing to shortage of nutrients and oxygen) and even death of a fruit.

from

At expressed lacks of water also future mother suffers. Malovodiye often is the reason of spontaneous abortions (abortions) and premature birth. During the second and third trimester future mother is disturbed by constant pains in the bottom of a stomach. In later terms there is an additional morbidity caused by the movements of a fruit.

Childbirth at lacks of water has the features too. The period of disclosure of a neck of a uterus usually drags on as there is no due pressure of a fetal bubble. Often primary and secondary weakness of patrimonial forces develops. At the same time fights from the very beginning painful, but unproductive. In the posledovy and early postnatal period (in the first 2 hours after the delivery) bleedings develop more often.

Fight against lack of water

Insignificant (400 - 700 ml) lack of water can be norm option. In this case recommend to future mother the guarding mode (the minimum physical activities), good nutrition, vitamin therapy and regular supervision by the doctor of a maternity welfare unit. If necessary make repeated ultrasonic research to exclude increase of lack of water. At increase of symptoms and confirmation expressed (less than 400 ml) lacks of water treatment in a hospital is necessary.

offer

For specification of the diagnosis and the choice of tactics of treatment of future mother hospitalization in maternity hospital. In office of pathology of pregnant women conduct the expanded examination including ultrasonic diagnostics (this research allows to judge rather precisely amount of amniotic waters), a kardiotokografiya (supervision over warm activity of the kid and sokratitelny activity of a uterus), laboratory methods (the general and biochemical blood test, urine). At suspicion on dribble of amniotic waters make dab on waters. Make an amnioskopiya for specification of quantity and density of waters - the endoscopic research allowing the doctor to estimate “approximately“ composition of waters without breaking integrity of fetal covers. This research can be conducted if the uterus neck already gets ready for childbirth, the channel of a neck of a uterus passes amnioskop - it is more often perhaps at the end of pregnancy. Medical tactics in many respects depends on the concrete reason which caused reduction of amount of amniotic waters. At identification of an amnionalny hydroyard (dribble of waters) order to future mother the high bed rest, plentiful drink, vitamin therapy, preparations directed to decrease in a tone of a uterus and prevention of infection of a fruit and covers. It is quite probable that in this case hospitalization and the treatment directed to prolongation (extension) of pregnancy will last before the childbirth. Treatment is carried out under a constant control of a condition of a fruit.

carry out by

At detection of a viral infection the antiviral and all-strengthening therapy, appoint the vitamins and preparations improving microcirculation (blood circulation at the level of small vessels). In this case upon completion of treatment and in the presence of positive dynamics future mother can be written out home under supervision of the doctor of a maternity welfare unit.

At detection of anomaly of development of fetal covers treatment also goes for preservation of pregnancy and prevention of development of a pre-natal infection. Therapy is carried out in the conditions of office of pathology of pregnant women under control of a condition of mother and a fruit.

carry out by

At confirmation of the diagnosis of a true perenashivaniye of pregnancy a planned amniotomiya - a puncture of a fetal bubble after which future mother naturally enters childbirth.

At timely diagnostics and an initiation of treatment the forecast for mother and the kid favorable.