Anomalies of labor
Violations of the preliminaries. Preparatory period, when identifiedPrecursors of childbirth, normally passes into the preliminaries, followed by childbirth. Usually the preliminaries last about 6 hours and gradually go into regular contractions. In the case of violations in the preliminaries, certain symptoms appear. They consist in irregular in frequency, intensity and duration of cramping pains in the lower abdomen, near the waist and sacrum. Such pain can last more than 6 hours. Together with them, the daily rhythm of wakefulness and sleep is disturbed, which leads to fatigue of the woman. The clinical picture is accompanied by an increased tone of the uterus, a high location of the presenting part of the fetus, an "immature" cervix of the uterus. Despite the fights, there is no dynamics in the opening of the cervix.
Weak labor activity (inertia of the uterus, hypoactivity) Consists in low intensity, frequency, andDuration of labor. This causes a slow smoothing of the cervix, a weak opening of the cervical canal and passage of the fetus. The weakness of labor is primary and secondary. So the primary weakness appears from the beginning of childbirth and remains until the end. And the secondary replaces normal labor activity. The frequency of occurrence of mild labor in the total population of parturients is 5-6%.
Excessive labor activity Common in nervous and easily excitableChildbirth. It is assumed that it is caused by violations of cortico-visceral regulation and the synthesis of contractile substances in high portions (acetylcholine, oxytocin, prostaglandin, etc.). The diagnosis of excessive labor activity is established on the basis of a very rapid and sudden onset of labor. It is expressed in violent bouts that follow one another at short intervals and cause rapid opening of the uterine pharynx. In this situation, childbirth is called impetuous, as they pass within 1-3 hours. Rapid births are dangerous for the health of women and children. Often they end with deep vaginal ruptures, cervix, perineum, clitoris. There is a high risk of premature placental abruption. The fetus often experiences intrauterine hypoxia and receives birth trauma. There are many cases where rapid births took place directly on the street or in transport.
Discoordinated labor activity. This pathology is associated with the lack ofCoordinated contractions of various departments of the uterus. Disturbances are observed between the left and right halves of the uterus, its upper and lower parts, between other parts of the uterus. Discoordination is manifested by hypertension of the uterus, convulsive contractions, contractions of the circular muscles of the uterus. With this pathology contractions become irregular, painful. A woman suffers from severe pain in the lower back and lower abdomen. Palpation of the uterus reveals an uneven muscle tension in its various parts. The study of contractile activity of the uterus on multichannel recording determines the arrhythmia and asynchrony of contractions in various departments. Usually there are fights of different duration and intensity, the uterus is in an increased tone, the cervix is often "immature", the opening is slow. The present part of the infant remains mobile for a long time or is pressed into the entrance to the small pelvis. After a certain time, the woman is tired, the birth slows or stops altogether. Owing to violations of uterine-placental blood circulation, hypoxia is often observed in the fetus. The consecutive and early postpartum periods are fraught with bleeding.