Rus Articles Journal

Artful loop. Obvity umbilical cords of

Watch only began when in an accident ward the persistent call was distributed. The pregnant woman accompanied by the husband and the woman of average years was on the threshold of maternity hospital (the mother-in-law as it became clear at conversation). All of them were very excited... whether

Should be anxious?

As it was h2, the woman arrived after passing of ultrasonic research in a maternity welfare unit. Without excessive prefaces of Yuli (so called the pregnant woman) told: “I agree to Cesarean section, relatives will bring necessary things now“.“ Wait, wait, let`s understand at first“, - I answered and invited Yulia in viewing. It became clear that pregnancy term at Yulia at the moment makes 36 weeks and on ultrasonography it is revealed obvity umbilical cords around a fruit neck. This fact very much disturbed the pregnant woman and her family therefore they decided to go to maternity hospital immediately.

the Umbilical cord (or umbilical kanatik) is the body which is functioning only during pregnancy and carrying out extremely important function of communication between an organism of mother and a fruit. The main component of an umbilical cord are vessels - one vein on which the arterial blood from mother to a fruit delivering all substances, necessary for activity, and oxygen, and also two arteries on which the blue blood of a fruit removes the fulfilled products of an exchange and carbon dioxide in mother`s organism flows.

Vessels of an umbilical cord are surrounded with special jellylike substance - vartonovy jelly which at the expense of the consistence carries out an important protective role - protects vessels from squeezing. Length of an umbilical cord averages 50 - 60 cm, thickness of 1,5 - 2 cm. If umbilical cord length more than 70 cm, it is considered long if less than 40 cm - short. Increase in length of an umbilical cord can lead to various pathological states, such as obvity an umbilical cord of a neck, trunk, fruit extremities, formation of knots of an umbilical cord which, in turn, share on true and false. It is important to note that about the fifth part of all born children umbilical cords are born with obvitiy, and not always it leads to violations of a pre-natal condition of a fruit. The matter is that, being in a uterus, until childbirth the kid does not breathe lungs therefore squeezing of a neck that always very much frightens future mothers, is not dangerous to it. Problems can arise when there is a violation of a blood-groove from - for tension or squeezings of an umbilical cord in view of repeated or hard an obvitiya.

What showed ultrasonography?

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according to ultrasonic research it is established that the fruit has no symptoms of a hypoxia (i.e. a lack of oxygen), when carrying out a dopplerometriya (research at which blood-groove speed in the main vessels of a uterus and a fruit) violations matochno is defined - placentary blood circulation is not revealed. The fruit corresponds to the term of 36 weeks of pregnancy, there are signs single an umbilical cord obvitiya around a fruit neck. “It is necessary when did me ultrasonography in 32 weeks, nothing about obvity was told“, - Yulya told.“ Quite perhaps, it then was not, and it is not obligatory at all that it will remain before childbirth“, - I answered.

it is valid, cases when they according to ultrasonography found obvity umbilical cords are in practice frequent, and the child was born without it. It can be, in - the first, is connected with the fact that umbilical cord loops on ultrasonography were near a fruit neck, but an obvitiya per se was not, and in - the second, at the movements of a fruit obvity umbilical cords was independently liquidated (of course, it happens, as a rule, at single obvitiya).

the Contributing formation factors an obvitiya an umbilical cord are the increased physical activity of a fruit which can be caused by a pre-natal hypoxia (i.e. a lack of intake of oxygen), abundance of water, increase of adrenaline in mother`s blood owing to stressful influences. It is natural that in most cases to an obvitiya of various parts of a body of a fruit the long umbilical cord brings.

we Make to

the diagnosis

completely to be convinced that Yulia`s kid feels well we made record of a kardiotokogramma (KTG). At KTG registration of warm activity of a fruit is made that is an informative indicator of its pre-natal state. For this purpose to future mother on a stomach attached the sensor which is connected to the device. Yulya lay on a bed on one side within 30 minutes, and the device wrote down heartbeat of a fruit. No pathological changes at KTG were revealed. Together with Yulia who already calmed down a little and became cheerful we left to the relatives expecting her. I explained to them that in this situation when we have premature pregnancy, absolutely normal pre-natal state of a fruit, only from - for an obvitiya of an umbilical cord is inexpedient to carry out a rodorazresheniye in the emergency order. The calmed pregnant woman with the husband and the mother-in-law went home.

For full definition of a pre-natal condition of a fruit needs to conduct a complex of researches which includes:

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If after carrying out all complex of inspections it is determined that the kid feels well, then only the fact an obvitiya an umbilical cord is not the indication for an operational rodorazresheniye. Such indications can arise or at the available signs of oxygen insufficiency (a fruit hypoxia), or at a combination an obvitiya an umbilical cord with other indications to Cesarean section. whether

operation Will be p>
?

Passed

about a month, I already managed to forget about that visit of Yulia when on the next watch I was invited to examine the arriving pregnant woman. Having come to an accident ward, I met Yulya and her husband again. It turned out that within 3 hours the woman is disturbed by nagging pains in the bottom of a stomach which became regular and more intensive an hour ago. At survey it is revealed that Yulia entered patrimonial process - the neck of a uterus is opened on 3 cm, amniotic waters did not stream.

to the Woman in labor 24 years, the real pregnancy at Yulia the first, gynecologic diseases, abortions and abortions were not. The last ultrasonography is executed in 39 weeks of pregnancy, according to its data obvity umbilical cords around a neck of a fruit remains. Estimated weight of a fruit of 3400 g pregnancy term at the moment 40 weeks. At an auskuljtation (listening of warm tones of a fruit through a forward belly wall a special tube - an obstetric stethoscope) heartbeat of a fruit clear, rhythmical, the heart rate of 144 beats per minute that meets standard (normal rate of warm reductions of a fruit makes 120 - 160 beats per minute). Fights at the time of receipt of weak force, in 10 minutes lasting 30 seconds. Having issued history of childbirth and having placed Yulya in prenatal chamber, to it at once made record KTG (kardiotokogramma). Carrying out KTG in labor is absolutely harmless and informative method of definition of a pre-natal condition of a fruit and its reaction to sokratitelny activity of a uterus what tactics of conducting childbirth at each patient depends on - she can give birth in the natural way or for the benefit of a fruit the rodorazresheniye by Cesarean section is necessary. In a case with Yulya of the given KTG depended what option of conducting childbirth will be chosen. Fortunately, no pathological changes on KTG were revealed. Yulia very much wanted to give rise. As it for this purpose had every chance, childbirth decided to conduct in natural patrimonial ways under careful monitor control of a condition of a fruit.

At an obvitiya of an umbilical cord it is very important to p to watch also a condition of a fruit, and the course of patrimonial process at mother, in labor can lead obvity umbilical cords to emergence of a number of complications.

the Most frequent complication arising at an umbilical cord obvitiya is an emergence of a hypoxia of a fruit which results from squeezing of vessels of an umbilical cord at its tension or hard an obvitiya around a trunk, a neck or the child`s extremities. Quite often it occurs while the fruit begins to move ahead on patrimonial ways.

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At numerous obvitiya of an umbilical cord forms a short umbilical cord which, in - the first, can interfere with advance of a fruit on patrimonial ways, and, in - the second, stretching at each fight, can lead to a premature otsloyka of a placenta from a uterus wall (normal the placenta separates from a uterus wall after the fruit birth) that leads to need of the emergency operational rodorazresheniye.

In rare instances at repeated umbilical cord obvitiya around a neck of a fruit can arise such complications as razgibatelny insertions of a head of a fruit that can complicate the child`s birth in the natural way. The matter is that at normal insertion of a fruit in mother`s basin the head is in a condition of moderate bending (in this case the chin of a fruit is pressed to a breast that allows a head to be inserted correctly into a cavity of a small pelvis and to take place without difficulties on patrimonial ways in most “favorable“ - that is in the smallest size) - it passes in such situation on patrimonial ways the smallest, most convenient size. The umbilical cord loops which are on a neck do not allow a head of the kid to be bent that leads to the fact that the head is established in mother`s basin not by a nape, and a cinciput, a forehead or even the person that can lead to considerable difficulties of the birth of a fruit and, as a result, to its travmatization.

To be fair needs to tell

that above-mentioned complications arise rather seldom and with the timely and correctly given help do not lead to adverse effects for mother and a fruit.

Childbirth

from the moment of Yulia`s arrival there passed 4,5 hours. Fights quickly enough became frequent, became stronger and long. During repeated survey on a chair it is revealed that the neck of a uterus revealed on 7 cm, the amniotomiya (tool opening of a fetal bubble) is made - 250 ml of light transparent amniotic waters streamed. According to KTG and regular listening of warm tones an obstetric stethoscope of a fruit the state it was satisfactory. Refused the offered medicamentous anesthesia of Yuli, having told what feels quite normally.

At an umbilical cord obvitiya the principles of conducting childbirth have a number of important points:

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