The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty since 2001.
Genera which proceed 4 hours or less primiparous and less than two hours multiparous called rapid delivery. Such pathological birth are anomalies of labor forces and are of the same type of dysfunction hyperdynamic contractile activity of the uterus, excessively strong labor.
The main difference between the rapid delivery that bearing-down sequence and periods of much shorter (the birth of the baby and placenta occurs in 1-2 attempts). The frequency of occurrence of this disease is 0.8% of the total delivery.
Rapid delivery for the duration of all the periods may correspond to normal indices (8-12 hours) and even in the period contractions be prolonged (incorrect insertion head or previa fetus). The main difference, as mentioned above, it is truncated and the bearing-down sequence periods.
Risk factors
A number of factors, the presence of which helps to identify high probability of rapid delivery in pregnant:
- a large number of parity (3 or more);
- there have been rapid or rapid delivery in the past, as well as birth defects or fetal stillbirth as a complication of childbirth;
- cervical incompetence (Both organic and functional);
- the large size of the pelvis;
- small size of the fetus;
- labile psyche.
Causes
The exact causes that lead to the development of an excessively strong labor are unknown. But doctors believe that the rapid delivery occur due to the following factors:
obstetric causes
These include:
- prenatal discharge of water,
- mismatch size of the fetal head and the birth canal,
- rigid (tight) the cervix,
- overstretched uterus due to polyhydramnios / multiple pregnancy or large fruit,
- abnormal location of the placenta,
- fetal presentation pelvic end.
As well as preeclampsia, anemia and Prolonged pregnancy.
The pathology of the reproductive system
This group includes:
- genital infantilism,
- malformations of sexual organs
- age (less than 30 and 18)
- various menstrual disorders,
- surgery on the uterus,
- fibroids, chronic endometritis and adnexitis,
- habitual miscarriage,
- abortion, infertility.
Extragenital (somatic) disease
Infection, intoxication, overweight, trauma, tumors, or cerebrovascular disease, thyroid disease, pituitary, hypothalamus, hypertension.
fruit factors
- intrauterine growth retardation,
- intrauterine infection of the fetus,
- gross fetal malformations,
- Rh-conflict pregnancy,
- fetoplacental insufficiency,
- postmaturity.
iatrogenic causes
This causes, due to the action of honey. employees or drugs:
- inadequate rodostimulyatsiya drugs (oxytocin, prostaglandin)
- unjustified opening of the membranes,
- inadequate anesthesia delivery,
- gruboprovodimye study and manipulation.
Signs of rapid delivery
Rapid delivery or begin suddenly and rapidly or after a long period of flow of the first fruit begins to rapidly move through the plane pelvic, without having to adapt to them, and the head of the fetus does not have time to be configured (reduced to the required size), and the broken biomechanism delivery.
Contractions during childbirth such pathological spastic, convulsive character, and their frequency is 5 or more for 10 minutes (rate: 3 contractions in 10 minutes).
The duration of each bout 120-180 seconds, uterine relaxation time is shortened, and each new battle superimposed on the previous one.
Perhaps the development of uterine tetanus ( "uterine cramps").
There is an increase of intrauterine pressure to 200 mm Hg and more. New mother is distressed.
May join autonomic disorders (nausea and vomiting, fever, profuse sweating, palpitations, pressure jumps "up-down").
The consequences of rapid delivery
Rapid delivery are dangerous both for the child and for the mother. However, when the competent doctors negative effects can be minimized.
Consequences for the child:
- acute fetal hypoxia;
- generic fetal injury (dislocated shoulders, broken limbs, spine and collarbone, cephalohematoma, Intracranial hemorrhage with subsequent development of paresis and paralysis);
- fetal death during childbirth due to placental abruption, birth trauma;
- damage to soft tissues of the fetus.
The consequences for the mother:
- placental abruption, and massive bleeding;
- genital tract injury (ruptures of the cervix, Vagina, perineum);
- divergence symphysis pubis;
- hypotonic or atonic bleeding in the third and postnatal periods;
- amniotic fluid embolism;
- delay parts of the placenta.
Some studies in pregnancy
Some studies in pregnancy
- Smears during pregnancy.
- Tests during pregnancy by trimester.
- Ultrasound during pregnancy.
- Urinalysis in pregnancy.
- Coagulation.
- Installing pessary.
- Glucose tolerance test.
- Homocysteine in pregnancy.
- Amniocentesis.
- Anesthesia during childbirth.
- Fetal CTG (cardiotocography)
- Cordocentesis.
- Epidural anesthesia during childbirth.