With speeding. What is fast childbirth dangerous by? Much of us had to hear
about the childbirth which took place in only several hours more than once. In a circle of future mothers such story about childbirth is perceived enthusiastically. However you do not hurry to envy: so quickly last childbirth most often negatively affects a condition of young mother and health of the newborn.
Fast and prompt childbirth is the complication developing owing to violation of normal regulation of patrimonial activity. Heavy ruptures of patrimonial ways, uterine bleedings and even complications for the kid can become result of such “haste“.
to understand the reason of development of “high-speed“ childbirth, it is necessary to remember of what stages patrimonial activity consists and what systems of a maternal organism are responsible for regulation of this major process.
Patrimonial activity represents fights - the rhythmical reductions of muscles of a uterus repeating through certain intervals of time and the lasting several seconds. Normal fights are regular, that is arise through an identical period, have the identical duration and intensity of reduction. In process of development of patrimonial activity of fight gradually amplify: their duration and force increases, and the pause between fights is reduced. During all childbirth the interval between fights remains the rest period: the uterus relaxes, and the maternal organism accumulates forces for the following reduction.the Periods of childbirth
Patrimonial activity is subdivided by
into three main stages - the period. the First period of childbirth begins
directly from the beginning of regular patrimonial activity, that is from the moment of emergence of fights. This stage of childbirth is called “the period of disclosure of a neck of a uterus“. Really, in this period gradual increase in an opening in the lower segment of a uterus - a uterus neck, or an obstetric pharynx is result of fights. The end of the first period of childbirth is full disclosure of a neck of a uterus, that is formation of such opening which is capable to pass the largest part of a fruit - a head.
the First period makes about 2/3 all durations of childbirth. Gradual, smooth stretching of an obstetric pharynx under the influence of the accruing fights allows to keep integrity of patrimonial ways and a wall of a uterus, and also to relieve a head of the kid of excessive pressure.the Second period of childbirth begins
with the moment of full disclosure of a neck of a uterus and comes to an end with the birth of the kid. This stage of patrimonial activity is called “the period of exile of a fruit“. After the uterus neck completely revealed, each reduction of a wall of a uterus advances a fruit on patrimonial ways towards “exit“. Owing to stretching of soft fabrics of a basin and shift of a rectum, close to a vagina, during fight the woman in labor has desire to make an effort. From here the second name of this period - potuzhny.
the Second period is much shorter than the first. During the potuzhny period the baby carefully, millimeter behind millimeter, moves apart fabrics of patrimonial ways of mother. Gradual, smooth advance of a fruit provides integrity of tissues of vagina and crotch, allows the child to adapt to the considerable pressure of walls of patrimonial ways, reduces risk of development of intra cranial hemorrhages of a fruit.
the Third period of childbirth is called “posledovy“. Really, at this stage there is a birth of everything that remained in a uterus after a fruit, - an afterbirth. The afterbirth (placenta), the remains of fetal covers (a wall of a fetal bubble) and an umbilical cord enters concept of an afterbirth. The third period of childbirth begins after the birth of the kid and comes to the end with allocation outside of an afterbirth. The third period the shortest and low-notable for the woman in labor; usually it proceeds several minutes and is followed by one fight. The first labor proceeding without complications and medical stimulation lasts on average about 11 - 12 hours. About 9 hours leaves this time for disclosure of a neck of a uterus, no more than 2 hours - for exile of a fruit and no more than 30 minutes - on the afterbirth birth.Regulation of patrimonial activity is carried out by
by means of interaction of two major systems of a maternal organism - nervous and hormonal. Female sex hormones - estrogen, prostaglandins - prepare patrimonial ways and nervous system of mother and a fruit to the beginning of childbirth, cause fights. The cerebral cortex in which by the time of the timely beginning of childbirth the patrimonial dominant (a congestion of the nervous cages regulating development of patrimonial activity) is formed exercises control of dynamics of patrimonial process.
At violation of interaction of hormonal and nervous system of the woman in labor various complications of patrimonial activity develop, including - fast and prompt childbirth.pathology Options
the childbirth lasting from 5 to 7 hours at for the first time the giving birth woman or from 3 to 5 hours - at repeatedly giving birth. Prompt childbirth at pervorodyashchy continues less than 5 hours, at repeated childbirth - less than 3 hours. Such high speed of patrimonial process is provided with excessively strong and frequent reductions of a uterus considerably exceeding the natural resistance of fabrics of patrimonial ways. As a result of it “a patrimonial pressure“ the fruit is literally pushed out from a maternal organism, without managing to adapt to sharply replaced environment conditions (pressure in a uterus cavity, in a vagina and at the exit from patrimonial ways considerably differs), leaving injuries in patrimonial ways of mother.
Risk factors of the fast prompt sorts
- frequent repeated childbirth (the multigiving birth women);
- rapid and prompt current of the previous childbirth;
- a hereditary factor (data on fast and prompt childbirth at the immediate family of the woman in labor - mothers, grandmothers, aunts, sisters);
- threat of interruption in the second half of pregnancy;
- istmiko - tservikalny insufficiency (an incomplete smykaniye of a uterine pharynx during pregnancy, insufficient for deduction of fetal egg);
- the heavy course of late toxicosis (gestoz) of pregnant women (the complication which more often is characterized by increase of arterial pressure, emergence of hypostases, protein in urine): the high figures of arterial pressure which are not giving in to therapy, considerable deterioration in work of kidneys, a liver, other bodies and systems of the pregnant woman, considerable suffering of a fruit;
- of a disease of mother, followed by permanent increase of arterial pressure;
- of a disease of mother, followed violation of a hormonal exchange (increase of function of a thyroid gland, adrenal glands, ovaries, a hypophysis); - - the acute infectious diseases of mother which are followed by defeat of the central nervous system;
- mental diseases and boundary nervously - mental conditions of mother (sharp psychosis, hysteria, neurosises);
- other diseases and states breaking nervously - hormonal regulation of patrimonial activity or a normal ratio of patrimonial forces and the resilience of patrimonial ways.
are Distinguished by several options of the accelerated course of childbirth.
Spontaneous fast childbirth is characterized by uniform acceleration of all process of childbirth, since disclosure of a neck of a uterus. The accelerated current of the first and second period of childbirth in this case is connected with the raised tensile properties of fabrics of patrimonial ways - necks of a uterus, walls of a vagina and tissues of a crotch. Low resilience of fabrics of patrimonial ways of rather increasing force of fights is the main reason for a rapid current of childbirth. Such option of fast and prompt childbirth occurs at the multigiving birth women, at future mothers with a giperestrogeniya (a surplus of the women`s hormones which are responsible for elasticity of fabrics), and also at istmiko - tservikalny insufficiency - an incomplete smykaniye of the cervical channel during pregnancy. Development of spontaneous fast childbirth is characterized by inadequately fast increase of force and duration of fights: within the first hour from the moment of the beginning of patrimonial activity of fight become frequent to 2 - 3 in 5 minutes. Childbirth at such option of succession of events lasts 4 - 5 hours, as a rule, without being followed by considerable damages to patrimonial ways. Such course of childbirth is more dangerous to the kid, especially at prematurity, the large size or existence of any pathology (oxygen insufficiency of a fruit during pregnancy, a syndrome of an arrest of development of a fruit, low adaptive opportunities, congenital malformations). Such pathologies of a fruit come to light at the ultrasonic research which is made not less than three times during pregnancy, by results of dopplerometrichesky inspection - studying of blood circulation in fruit vessels, by results of supervision over heartbeat of a fruit - kardioto - kografichesky research.
Spastic patrimonial activity at a rapid and prompt current of childbirth is characterized by one-stage development of inadequately frequent, long and painful contractions which are actually deprived of rest intervals. Childbirth begins with the rough and long fights arising to 5 and more times in 10 minutes at once. The woman in labor at such development of patrimonial forces from the very beginning of childbirth feels considerable discomfort, behaves uneasily, complains of the expressed morbidity of fights and lack of the periods of rest. Usually such childbirth is followed premature izlitiy waters (waters stream prior to fights), nausea, the vomiting raised by sweating, tachycardia (heartbeat increase). In this case the speed of childbirth is connected with spastic (sharp, inadequately strong and very frequent) the reductions of a muscle of a uterus which are followed by significant gaps of a neck of a uterus, walls of a vagina, crotch, and sometimes and the uterus. In labor often there are such dangerous complications as a premature otsloyka of a placenta, violation of a placentary blood-groove and uterine bleeding. At a fruit as a result of spastic labor pains injuries, hypodermic hemorrhages, kefalogematoma (hemorrhages under a periosteum - a cover of bones of a skull) and cerebral hemorrhages are formed. The majority of these complications are extremely dangerous, many threaten life of mother and a fruit. Childbirth in this case lasts no more than 3 hours, the birth of the kid occurs for 1 - 2 attempts following at once formation of full disclosure of a neck of a uterus.the Fast childbirth which is characterized by mainly prompt birth of a fruit differs in
from two previous types of acceleration of process. The main difference consists in the broken ratio of duration of the first and second period of childbirth. At such option of a course of childbirth the disclosure period on time can significantly not differ from normal childbirth or is slightly accelerated, and process of exile of a fruit happens in only several minutes. Such prompt appearance of the kid on light after the previous normal period of disclosure meets at premature birth, a hypotrophy more often (small weight with a normal length) a fruit, the big sizes of a bone basin of the woman in labor, and also at an unreasonable medicamentous rodostimulyation. At mother at such current of the potuzhny period heavy defects of soft tissues of vagina and crotch (significant gaps, hematomas) are formed. The prompt birth is dangerous to a fruit by development of injuries back and a brain.
of the Consequence of fast childbirth
Unfortunately, the course of childbirth in most cases accelerated provokes development heavy, time of life-threatening complications at mother and a fruit.
prompt patrimonial process is dangerous To mother by development of the following complications:
- of the Trauma of soft fabrics of patrimonial ways (ruptures of a neck of a uterus, walls and the arches of a vagina, crotch), rupture of a body of a uterus - complication at which danger in connection with massive bleeding threatens life of the woman in labor: in this case childbirth always comes to an end with operation.
- the Divergence of pelvic bones in the field of a lonny joint: complication is followed by the expressed pain syndrome. Treatment consists in observance of the fixed prone position on a back on a firm surface before disappearance of symptoms (usually 1 - 1,5 month). at
- the Premature otsloyka of a placenta - complication, extremely life-threatening swear also a fruit; in this case, to save lives of mother and a fruit, the emergency operation of Cesarean section is made.
- Violation of a placentary blood-groove owing to a uterus hyperactivity - the state provoking oxygen starvation of a fruit (a sharp hypoxia).
- Violation of office of a placenta in the third period of childbirth, a delay of a segment of a placenta, covers in a uterus cavity. In this case under an intravenous anesthesia make manual office of a placenta or its remains.
- Hypotonic (caused by a low sokratimost of the uterus which “overtired“ in labor) bleeding in the first 2 hours after the child`s birth. At development of such complication emergency measures on a bleeding stop are undertaken: introduction of the preparations increasing sokratitelny ability of a uterus (oxytocin, pituitrin, metilergo - metrin), zamenny blood transfusion and krovozamenitel. If necessary make manual inspection of a uterus that promotes reduction of her muscles. The most widespread complications for the kid at fast and prompt childbirth: Injuries of soft fabrics (hemorrhage in hypodermic cellulose).
- of the Injury of clavicle, humeral bone: the kid does not manage to finish turn after the head birth, and a coat hanger is born in a slanting size. Kefalogematoma`s
- (hemorrhages under a periosteum of bones of a skull).
- Intra organ hemorrhages (liver, kidneys, adrenal glands).
- Violation of brain blood circulation and death of cells of a brain at the expense of an angiospasm of a brain or hemorrhage (strokes, microstrokes), the increased intra cranial pressure, the violations causing subsequently from the central nervous system, in the worst option - life-threatening or causing an invalidization.
- of the Spine injury.
- the Sharp hypoxia (oxygen starvation) of a fruit in labor - a state, life-threatening the kid. Quite often at prompt attempts the baby is born in a condition of asphyxia, i.e. with violation of respiratory function. In this case to the newborn hold resuscitation events.
Slightly more slowly...
of Development of the majority of complications of prompt childbirth, enough terrible both for mother, and for the kid, it is possible to avoid. For this purpose it is necessary in time (in advance, during supervision in a maternity welfare unit) to reveal the contributing factors in the anamnesis of future mother indicating high probability of development of “speeding“ in labor. At identification of a high risk (the raised uterus tone, a syndrome of an arrest of development of a fruit, violation of a placentary blood-groove and other problems with which it was not succeeded to cope in the conditions of a maternity welfare unit) to future mother appoint planned prenatal hospitalization in office of pathology of pregnancy of maternity hospital. In this case at the very beginning of development of patrimonial activity doctors will be able to take all measures “to brake“ the high-speed mode of patrimonial activity, having brought closer the course of childbirth to normal time and having prevented development of complications.
can Suspect threat of too fast development of patrimonial activity of that case when in the first 20 - 30 minutes the frequency of emergence of fights obviously increases. For example, at normal dynamics of patrimonial activity the first fights last about 10 seconds, alternate an interval usually not less than 20 minutes, and reduction of a pause till 15 minutes will happen through 1 - 1. 5th hour. At “the accelerated option“ already in half an hour from the moment of the first fight the interval will be reduced to 4 - 5 minutes, at the same time intensity of fights will increase noticeably. In this case it is necessary to go to the nearest maternity hospital: than earlier future mother and the kid I will rendertsya under supervision of doctors, the there are more chances to correct patrimonial activity and to avoid complications.
Prompt childbirth is characterized by “the rough beginning“. In this case the first fights are painful, long and too frequent. In a case when fights cause high degree of discomfort at once and separate from each other a pause 10 minutes and less, it is necessary to go to the nearest maternity hospital immediately.medical measures are directed to
in case of development of fast and prompt childbirth to decrease in intensity of patrimonial activity, i.e. to reduction and an urezheniye of fights. In a reception future mother is stacked on a wheelchair; forbid to rise and go. The cleaning enema when diagnosing prompt patrimonial activity is not made as this procedure has rodostimuliruyushchy effect. The woman in labor on a wheelchair is brought to delivery room and shift to a bed, having it on one side, opposite to the provision of a back of the kid. Such position of the woman in labor as much as possible extends time of childbirth.
Medicamentous correction of prompt development of patrimonial activity consists in introduction to future mother of the medicines reducing sokratitelny activity of a uterus. Preparations are for this purpose used giniprat, partusisgen. brikanit, nifedipine, verapamil, etc. For reduction of a pain syndrome, stabilization of arterial pressure and decrease in excitability of the central nervous system appoint magnesia, atenolol. If necessary both the first, and second period of childbirth is spent under epiduralny anesthesia (anesthesia which entrance the anesthetizing preparation is entered into the area over a cover of a spinal cord at the level of lumbar vertebras, anesthetizes a lower body). For prevention of development of violation of a placentary blood-groove and a sharp hypoxia of a fruit in labor appoint the preparations improving blood supply of the kid - pentoksifillin, etc.are also delivered by
in position of the woman in labor lie to the side opposite to a fruit back arrangement. Right after office of an afterbirth careful survey of fabrics of patrimonial ways at suspicion on a delay of a segment of a placenta is made, covers or a rupture of a wall of a uterus conduct manual examination of a cavity of a uterus.
In the early postnatal period to young mother are appointed by the preparations improving involution of a uterus (its return to the normal sizes) - methylergometrine, oxytocin.
the Period of adaptation (restoration) of a fruit after fast and prompt childbirth can increase till 5 - 7 days that is reflected in a possibility of applying to a breast, terms of vaccination and an extract.to
for lack of complications at mother and the kid recommends their joint stay in postnatal chamber. Such mode promotes elimination of a patrimonial stress, fast involution of a uterus and timely approach of a lactation thanks to a possibility of frequent applying of the kid to a breast.