This article will address the issue of weakness of labor activity. We will tell you in detail about the causes, symptoms, consequences and resolution of childbirth.
For let's denote what it is. The weakness of labor is the lack of activity of the uterus. That is, childbirth is difficult and lengthy, since the uterus does not contract well, the cervix opens with difficulty, and the fetus comes out very slowly and difficultly. Childbirth does not always go well, as expected, there are anomalies in labor activity. You will learn about one of them in great detail from this article.
Weak labor activity
No matter how sad it may sound, but anomalies in labor activity are quite common. The reasons for this phenomenon are quite numerous. Now we will talk about the weakness of the genericprocess.
This is one of the possible violations of labor activity. With this diagnosis, the contractile function of the uterus, which is necessary for the expulsion of the fetus, is weakened. This is due to:
- low myometrial tone;
- rare contractions;
- weak amplitude of contractions;
- predominance of diastole;
- the contraction period lags far behind the relaxation period;
- delayed cervical dilatation;
- slow fetal advance.
More detailed symptoms will be presented in another section. Now let's look at some statistics. This diagnosis in obstetrics and gynecology is the most popular, as it is a very common complication of childbirth and the cause of various pathologies of both the mother and the child. Statistics claim that more than seven percent of childbirth is complicated by the weakness of labor activity. And one more fact: this diagnosis is established more often by women who give birth to their first child. As a rule, subsequent births pass without any difficulties, however, there are cases of diagnosing weakness of labor activity during subsequent births.
Reasons
We explained what the weakness of labor activity is. The reasons can be many factors. We propose to list them. The reasons for the weakness of labor activity can be:
- morphological inferiority of the uterus;
- lack of hormonal regulation of the birth process;
- functional inertia of nerve structures;
- extragenital diseases;
- hypoplasia;
- myoma;
- chronic endometritis;
- adenomyosis;
- bicornuate uterus;
- saddle uterus;
- medabortion;
- scraping;
- conservative myomectomy;
- scars after treatment of cervical erosion (if the woman has not previously given birth).
There are some more reasons to mention. Weakness of tribal forces may arise due to an imbalance of factors that affect labor activity. Positive factors include the following:
- prostaglandins;
- estrogens;
- oxytocin;
- calcium;
- mediators and so on.
Affect negatively:
- progesterone;
- magnesium;
- enzymes that destroy neurotransmitters and others.
It is very important to note that women suffering from some disorders (vegetative-metabolic) often face this problem during childbirth. These violations include:
- obesity;
- hypothyroidism;
- hypofunction of the adrenal cortex;
- hypothalamic syndrome.
The age of the primiparous also has a great influence. If the girl is very young or her age exceeds 35 years, then labor can be difficult. The period at which labor activity began is also important. Weakness of the uterus can be the cause of a delayed pregnancy or premature.
If the pregnancy is multiple, then this pathology is possible during childbirth. With multiple pregnancyuterine distension occurs. Overstretching can also occur with a large fetus or polyhydramnios.
Petite girls often face difficulty in labor, as a narrow pelvis is also the cause of weak work of the uterus. The reason is the disproportion between the size of the child and the pelvis of the woman.
The reasons are still very numerous, unfortunately, it will not be possible to list them all. Now let's highlight some of the most popular of them:
- overwork;
- mental stress;
- physical activity;
- bad food;
- lack of sleep;
- fear of childbirth;
- discomfort;
- bad delivery service and so on.
Thus, we can classify all causes as follows:
- from mother's side;
- pregnancy complications;
- from the side of the child.
Views
Weakness of labor activity can occur absolutely at any stage of childbirth. In this regard, it is customary to highlight some types of weakness:
- primary;
- secondary;
- weak attempts.
We offer a little more detailed consideration of each species separately.
Primary weakness of labor activity is characterized by inactive contractions in the first stage of labor. They are very weak, short and not at all rhythmic. It is important to note that with primary weakness, an underestimated uterine tone (less than 100 mm Hg) is noticed. At this stage, the woman is able to diagnose the problem herself. Howdo it? Record ten minutes and count the number of contractions during this period. If the number does not exceed two and you practically do not feel them, then the diagnosis was confirmed. You can also measure the time of one contraction, it should be more than 20 seconds in the absence of weakness in labor. Diastole, or rest period, is almost twice as long. How can the palpability of contractions indicate a problem? It's simple, if they are painless or slightly painful, then the pressure from the uterus is not enough to open the cervix.
Secondary weakness of labor activity is characterized by a weakening of the intensity of the work of the uterus. Prior to this, contractions may have been normal. The causes of development are the same as with the primary weakness of the ancestral forces. Another indicator is the progression of the opening of the uterine os. If progress is not visible after five to six centimeters of dilatation, then we can confidently speak of secondary hypotonic dysfunction of the uterus.
While primary and secondary weakness occurs in ten percent of cases of adverse births and is typical for primiparas, then weakness of the puerperal period is extremely rare (two percent of all cases of difficult births), and it is typical for women with multiple births or with obesity.
Symptoms
Symptoms of primary weakness of labor include:
- reduced uterine excitability;
- reduced uterine tone;
- reduced frequency of contractions (down to two in ten minutes);
- short duration of contractions (up totwenty seconds);
- strength of contractions does not exceed 25 mm Hg. Art.;
- short reduction period;
- extended rest period;
- no increase in intensity and frequency;
- painless or painless contractions;
- delayed change in the structure of the cervix (this includes shortening, smoothing and opening).
All this can significantly increase the overall time of labor. This, in turn, affects the mother and the child badly. The woman in labor is very overworked, early expulsion of water is possible.
Symptoms of secondary weakness:
- weakening of the intensity of contractions (perhaps even their complete cessation);
- weakening of tone;
- decrease in excitability;
- no progression of cervical dilatation;
- stop the progress of the fetus through the birth canal.
This is no less dangerous than the initial weakness. The child may develop asphyxia or may die. For the mother, this is dangerous due to the possibility of infection of the uterus, birth injuries. Prolonged standing of the baby's head in the birth canal can lead to the formation of bruises or fistulas.
Diagnosis
This section will focus on diagnosing the problem of weakness (primary and secondary) of labor. The diagnosis of primary weakness is based on the following:
- decreased uterine activity;
- reduced neck smoothing rate;
- delayed opening of the cervix;
- long standing fetus;
- increased labor time.
ImportantIt should be noted that the partogram (or graphic description of childbirth) has a great influence on the diagnosis. Everything is indicated in this diagram:
- neck opening;
- fetal promotion;
- pulse;
- pressure;
- baby heartbeat;
- contracts and so on.
If there is no progress in dilatation of the cervix for two hours, which is clearly shown in the partogram, then this diagnosis is made.
The diagnosis of secondary weakness is based on these indicators:
- partogram;
- KTG;
- listening to the heartbeat.
This is necessary so that the fetus does not develop hypoxia. There are some complexities of the birth process that are symptomatically similar to weakened labor. These include:
- pathology of the preliminary period;
- discoordination of labor activity;
- clinically narrow pelvis.
Treatment
It is important to note that the treatment is selected individually for each woman in labor. When treating, the doctor must take into account all the data that he has (the condition of the woman and the baby).
A good remedy for weak labor is the drug sleep technique. To do this, special preparations are introduced so that the woman has a rest, then labor activity may intensify.
If this does not help, then they resort to puncture the fetal bladder. After this procedure, labor activity becomes much more intense. Costsnote that the puncture is carried out only if the neck is ready.
Sometimes doctors resort to drug stimulation. Now we will briefly consider the drug "Miropriston" to stimulate labor. This drug should be taken strictly under the supervision of doctors. It suppresses progesterone, which has a beneficial effect on the contractile activity of the uterus.
Delivery
If no methods have helped, including Miropriston to stimulate labor, the doctor can perform an emergency caesarean section. What techniques are carried out before the operation:
- drug sleep;
- amniotomy;
- drug stimulation.
Among other things, there may be additional indications for surgery. There is a list of contraindications to labor induction (narrow pelvis, uterine scars, life threatening, and so on).
Prevention
We have examined in detail the issue of the weakness of labor activity. Clinical recommendations for prevention can be given by the obstetrician-gynecologist who manages your pregnancy. He should talk about possible complications during childbirth and conduct physical and psychological preparation of the woman in labor. In addition to rhodostimulation, prevention of possible complications in the fetus is mandatory.
Consequences
What are the complications of labor weakness? For mom, this could be:
- hematoma formation;
- fistula formation;
- possible infection.
The following complications are possible for the child:
- hypoxia;
- acidosis;
- cerebral edema;
- death.
It all depends on the professionalism of the doctor. With proper stimulation and strict control of the condition of the child and mother, there should be no consequences.
Forecast
Now briefly about predicting the weakness of labor activity. As mentioned earlier, it all depends on the professionalism of the doctor and the psychological state of the woman. Do not panic, but listen to the recommendations of a specialist. Complications after obstructed labor are rare.
Proceedings of subsequent births
The weakness of labor during the first birth does not mean that all subsequent ones will proceed in the same way. Primary and secondary weakness is common in women who give birth to their first child. A small percentage of multiparous women may experience weakness in the bearing period.
