Фактори, що сприяють розвитку слабкості пологової діяльності

Abstract

В статті представлені результати ретроспективного аналізу історій пологів із слабкістю пологової діяльності та з нормальним її перебігом. Визначені фактори ризику розвитку слабкості пологової діяльності, серед яких: вік жінки до 18 років і після 30 років, пізнє менархе, різні порушення менструального циклу, ускладнений перебіг даної та попередніх вагітностей і пологів, запальні процеси жіночих статевих органів, екстрагенітальні захворювання. Результати дослідження свідчать, що правильно зібраний анамнез, ретельно вивчений перебіг даної вагітності, адекватна оцінка стану вагітної і плода дає можливість лікарю прогнозувати можливість розвитку СПД. Своєчасно застосовані при цьому профілактичні заходи дадуть змогу зменшити ризик виникнення перинатальних ускладнень. В статье представлены результаты ретроспективного анализа историй родов со слабостью родовой деятельности и с ее нормальным течением. Определены факторы риска развития слабости родовой деятельности, среди которых: возраст женщины до 18 лет и после 30 лет, позднее менархе, различные нарушения менструального цикла, осложненное течение данной и предыдущих беременностей и родов, воспалительные процессы женских половых органов, экстрагенитальные заболевания. Результаты исследова ния показывают, что правильно собранный анамнез, тщательно изученное течение данной беременности, адекватная оценка состояния беременной и плода дает возможность врачу прогнозировать возможность развития СПД. Своевременно примененные при этом профилактические мероприятия позволят уменьшить риск возникновения перинатальных осложнений. Nowadays, the uterine inertia remains a serious complication, that aggravates childbirth and becomes dangerous to the health of the mother and fetus. The aim of the study was to determine factors that cause the development of uterine inertia. A comparative study was performed by retrospective analysis of 120 childbirth case histories, accompanied by the weakness of labor activity (WLA) – group I, and 400 birth history with normal labor activity (NLA) – group II. Analysis of the women age composition stated that WLA is noted most often before the age of 18 and after the age of 30. In primiparas, childbirth was more often complicated by WLA – 98 cases (81,7%), while the II group consisted of 238 (59.5%) women. In a retrospective study of the group I birth histories, delayed menarche was revealed in 6.7% of women, whereas in group II only in 0.5% of cases. Menstrual disorder, correspondingly was observed in 14.2% and 2.3% of women. Infertility in anamnesis was noted in 14 women (11,7%) with WLA and 9 women (2,3%) with NLA. Inflammatory processes of female genital organs were recorded in anamnesis in 19 women with complicated by WLA deliveries (15.8 %) and in 21 women with NLA (5.2%). The threatened miscarriage among women whose childbirth was complicated by WLA was observed in 37 cases (30.8%), whereas in the control group was 70 (17,5%). Pregnancy of 5.2% of women in group I was accompanied by polyhydramnios, and in group II – 2.8%. Big fetus was stated in 34 cases (28,3%) in WLA, while in 55 cases (13.8%) in NLA. Postmaturity was noted in 12.5% of cases among women with complicated by WLA childbirth, whereas it was 5 times less (2.5%) in the control group. Pathological preliminary period was observed in 14 women whose childbirth was complicated by WLA and in 2 cases during NLA (11.5% and 0.5% correspondingly). It was stated 100 term birth among 120 women of group I, and 361 among women of group II, which in turn was 83.3% and 90.2%, correspondingly. In 15% of cases in 120 deliveries, which were complicated by WLA, the delayed birth occured, which is 6 times higher than among women of the control group. In group I the birth took place in cephalic presentation in 91.7% of cases and 8,3% of cases in breech presentation, whereas in group II – 98% and 2%, correspondingly. Among the childbirth with WLA, the untimely discharge of amniotic fluid was noted in 54,2% of cases, whereas in the control group the premature rupture of membranes accompanied birth only in 22.3%. Also in WLA placenta was located in the bottom of the uterus 2 times often than in NLA. Thus, the risk factors that provoke development of WLA include: the age of the woman before18 and after 30 years, delayed menarche, various menstrual disorders, complications during present or previous pregnancies and childbirth, inflammatory processes of female genital organs, extra-genital diseases. The results of the study suggest, that properly collected anamnesis, carefully studied course of the current pregnancy, an adequate assessment of the pregnant woman and fetus allow the physician to predict the possibility of WLA development. Timely administered preventative measures will reduce the risk of perinatal complications.