department of obstetrics and gynecology medical and of health preventive faculty obstetrics iv...

Department of Obstetrics and GynecologyMEDICAL AND OF HEALTH PREVENTIVE

  FACULTY

OBSTETRICSIV course

Anomalies of patrimonial activity

WOMB

prostaglandins myoglobinOXYTOCIN ATPkinins actomyosinserotonin CALCIUMacetylcholine RNAcatecholamines GLYCOGENoestradiol

Downward TRIPLE GRADIENT

- PEYSMEKER- pacemaker

- DOMINANT BOTTOM

- TOP-DOWN WITH FORCE Descending

momentary MAXIMUM REDUCTION AND PAUSE

Downward TRIPLE GRADIENT

SCRUM

• contraction

retraction

distraction

contractions are characterized

* Regular * Certain duration * Force

Action uterine contractions

Phase 1 stage of labor

* Латентная: открытие зева до 4 см * Активная: открытие зева от 4 до 8-10см

during childbirth• The rate of cervical dilatation

- Nulliparous least 1 cm / hour, - Multiparous - 1.5-2 cm / hour

• The average duration of labor - The first birth - 8 hours, rarely 18chas - Repeated births - 5:00 seldom 12:00

Anomalies of patrimonial activity

Pathological preliminary periodWeak labor FORCES - PRIMARY - SECONDARY - WEAKNESS attempts

• EXCESSIVE Stormy generic activities - Prompt delivery, FAST DELIVERYIncoordination of labor - incoordination - Dystocia CERVICAL - Hypertonicity of the lower segment - Uterine tetany

Pathological preliminary period

• Irregular contractions, sometimes sharp pain that lasts more 6-8hoursThese contractions disrupt the rhythm of sleep and bodrostvovaniyaFatigue mothersDo not lead to the disclosure of the cervixLead to the appearance of fetal hypoxia

Clinical management is defined* * Severity of clinical manifestations

* The status of the cervix* The status of the fetus* Is there a premature discharge of water or not.

Treatment of pathological preliminary period:

medication sleepanesthesia

Amniotomy - the presence of defective membranes (flat) may be the

cause of pathological preliminary period. Amnitomiya promising in the

presence of mature or maturing of the birth canal.

The main criterion for the flow of labor

• The characteristics of contractions (regular, strong enough)

* The dynamics of disclosure uterine os, nulliparous disclosure uterine os 1 cm per hour in multiparous 2 cm per hour.* Promotion of the head through the birth canal

Prolonged labor: Due to the weakness of labor

PRIMARY• preeclampsia

extragenital diseasesABORTIONinfantilismBIRTH AFTER 30 YEARS

• Uterine malformationsperenashivaniePelvic E previa

• Scar on the uterus gynecologic diseases MYOMAENDOMETRITIS Prenatal outpouring of waterHyperextension of the uterus (multiple pregnancy, polyhydramnios

• Large fruit, multiparous) !

Because of the weakness of labor

ЭГЗ ЭГЗ УСТАЛОСТЬ, ГОЛОДУСТАЛОСТЬ, ГОЛОД

ГИПЕРСТИМУЛЯЦИЯ МАТКИГИПЕРСТИМУЛЯЦИЯ МАТКИ

НЕСООТВЕТСТВИЕ НЕСООТВЕТСТВИЕ РАЗМЕРОВ РАЗМЕРОВ ПЛОДА ПЛОДА РАЗМЕРАМ РАЗМЕРАМ ТАЗА ТАЗА МАТЕРИМАТЕРИ

SECONDARY 1. Women aged and young age 2. Women with overstretching of the uterus (large

fetus, multiple pregnancy, polyhydramnios). 3. Multiparous, mnogoberemennye, numerous

abortions with curettage, ie in the presence of degenerative and inflammatory changes in the myometrium.

4. In women with menstrual dysfunction and hormonal balance

5. Hypertrichosis, obesity

DIAGNOSIS Prolonged labor 1. Characteristics of contractions: the weak,

short 2. Insufficient dynamics of cervical

uterus (normally 1 cm per hour) - 0.5 cm per hour.

3. To clarify the dynamics of the used methods for determining the external data and vaginal

examination -Partogramma4. Diagnosis should be delivered within 3-4

hours.

Treatment: amniotomy

Rodostimulyatsiyacesarean

OVERTORQUE labor.The clinical picture of the turbulent

labor

Vaginal examination fast speed disclosure of uterine os.

treatment:antispasmodics

sedation

DISKOORDINIROVANNAYA of laborContractions -Different strength, duration, and

intervals, sharply painful, mosaicism.Increased uterine tone especially in the lower

segment, rigid edges of uterine os.Slowing promotion fetus through the birth canal

difficulty urinating

DISKOORDINIROVANNAYA of laborCAUSES OF

Uterine malformations

· Anatomical changes of the cervix (after diathermocoagulation)· Women with unstable nervous system, increased sensitivity to pain reaction

Осложнения

• complications: Premature rupture of membranes prolonged labor Increased percentage of septic infections fetal hypoxia A high percentage of operational delivery

TACTICSamniotomy

Oxytocic

Caesarian

I WAS born YOURSELF!