Вт, 07 июн 2016 Автор: Марина Гришина
Uterine, cervical and perineal ruptures are one of the most common
occurring complications of childbirth.
It can be either spontaneous or due to interference.
physicians.
For those who give birth for the first time, breaks occur 3 times more often than
in multiparous.
This is primarily due to the inexperience of the woman in labor.
Why breaks occur, is it possible to avoid them and how is it
do?
Contents
Gaps during childbirth – causes and types
100% to say about whether there will be gaps or not, can neither
one doctor. In most случаев виной всему является неопытность и
unpreparedness of the woman. At peak times she loses
composure, panicked and no longer obey the doctor.
However, there are times when even experienced and well-prepared
to childbirth women get breaks. This can contribute
many reasons. Before we talk about them, let’s see
what kind of breaks there are.
Conventionally, they can be divided into three types:
● uterine rupture;
● cervical rupture;
● rupture of the perineum (damage caused by strong
stretching the birth canal).
The factors that tend to rupture during labor are very
lot. Among the common:
● inflammatory processes (chronic or in stage
aggravations);
● genital infections (eg, thrush);
● inexperience of the woman in labor (in most cases, the woman simply does not
listens to the doctor and gives in to panic);
● Too fast delivery (with rapid progress
fetus by the birth canal);
● sluggish labor (swelling of the perineum, and
exposure to hormones, cervical rupture occurs);
● Mature age of laboring woman;
● repeated delivery after cesarean section;
● negligence of health workers (for example, when
pulling the child);
● tone of the uterus and pelvic muscles;
● physiological feature (when the distance from the vagina to
the anus is more than 7 cm).
Uterine rupture during childbirth: treatment, consequences
Uterine rupture during delivery does not happen often. This kind
The breaks are the hardest. It can occur by the following
reasons:
● functional obstacles disrupting normal movement
fetus through the birth canal (narrow pelvis, dystocia of the cervix);
● mechanical obstacles (large fetus, uterine abnormalities);
● repeated delivery after cesarean section, abortion or several
previous birth history;
● obstetric factor (pulling of the fetus, the imposition of forceps);
● abdominal trauma;
● sluggish delivery;
● Stimulation of labor when it is not necessary.
Uterine tears are divided into several types, depending on
localization, course and nature of damage.
The localization of the gap can be in:
● Mother’s Day;
● the body of the uterus;
● lower segment;
● also rarely, but there is a complete separation of the uterus from the arches.
uterine rupture may be:
● in the form of a crack;
● incomplete, that is, not penetrating into the abdominal cavity;
● complete.
The clinical picture begins with the threat of uterine rupture, then
goes into the process that has begun, after which (if the measures were not
taken or unsuccessful) the gap is considered
perfect.
How to treat
If a uterine rupture occurred during delivery, before
Doctors have the task: to do everything possible for a speedy outcome
childbirth to save the baby and stop the bleeding from mom.
At full разрыве матки роженице делается экстренное кесарево
cross section. After removing the baby, the uterus is stitched and
the blood stops.
What is the danger
Uterine rupture can negatively affect both the fetus and
mom If not detected in time, the fetus may die in
womb due to acute oxygen starvation (hypoxia). Mom’s
turn, hemorrhagic shock caused by a large
blood loss. The nervous system may be impaired,
blood circulation.
How to avoid
Preventive measures to be taken to avoid
uterine rupture during labor:
● regular visits to an obstetrician-gynecologist;
● the passage of all planned ultrasounds for the early detection of factors
which may affect the gap;
● correct and timely choice of delivery;
● monitoring of the fetus, especially if it has a large
weight;
● diagnostics and control of a threatening or beginning rupture
uterus.
Rupture of the cervix during childbirth: treatment, consequences
Rupture of the cervix – a phenomenon that is often accompanied by childbirth.
The gap may be spontaneous (for example, if a large fruit,
mom’s narrow pelvis or fast delivery) and violent
(operations aimed at accelerating labor).
Doctors divide the cervical rupture into several degrees:
1. gap, the size of which is not more than 2 cm, is with one or
both sides;
2. gap size greater than 2 cm, but does not reach the arches
vagina;
3. the gap that comes and goes to the vaults of the vagina.
The first two degrees are considered uncomplicated ruptures of the neck.
uterus. In the latter case, the damage will be considered complicated.
It touches the inner uterine throat, abdominal and pelvic cavity.
Also, a third-degree rupture can affect the fat layer,
located around the uterus.
How to treat
Rupture of the cervix is treated by surgery:
● defects are sutured (in rare cases it may not be necessary
– with non-bleeding and superficial wounds);
● operation with opening of the abdominal cavity (used at rupture
third degree, the defect is sutured directly in the uterus).
What is the danger
Such ruptures at birth can have serious consequences:
Inflammation of the neck;
● inflammation of the uterine lining (postpartum endometritis);
● hematoma in the fat layer of the uterus;
● hemorrhagic shock (disruption of the nervous system,
blood circulation).
How to avoid
To avoid rupture of the cervix, you must adhere to
some rules:
● eliminate excessive physical and emotional stress;
● get registered on time and regularly visit a gynecologist;
● undergo all necessary tests and examinations to
time to detect possible violations;
● plan pregnancy no earlier than two years after
surgeries on the uterus (if any);
● taking vitamins and sedatives (only
the appointment of the attending physician);
● timely evaluation of indications for natural or
artificial childbirth;
● moderate pain relief during childbirth.
Perineal rupture at birth: treatment, consequences
Rarely childbirth is smooth and without breaks. More often
damage to the crotch. This gap represents
sprains of the birth canal due to strong pressure on the pelvic muscles.
Often this particular type of trauma in childbirth depends on the preparedness
mothers to this process.
Perineal rupture during childbirth is divided into 3 degrees depending
the nature of the damage:
1. Damage to the skin of the perineum only.
2. Damage to the skin, perineal muscles and vaginal walls.
3. Damage to the third degree may be incomplete, complete and
central. In the first case, in addition to the skin, muscles and walls of the vagina,
damaged and muscle, which closes the rectum. At full
rupture occurs rupture of the walls of the rectum. Central gap
crotch during childbirth is very rare and is characterized
damage to the posterior vaginal wall, pelvic muscles and skin
crotch At the same time, the posterior commissure and the pectoralis muscle
guts remain intact.
How to treat
Perineal tears should suture immediately after injury.
(should take no more than half an hour). This is done under the local
anesthesia. Stitches can be applied temporary (which should be later
shoot) or self-absorbable.
Twice a day, stitches must be processed during the week.
antiseptics. If they were imposed temporary, then they are removed at 4-5
day.
To keep the seams apart, the young mother is not recommended to sit in
for 2 weeks.
What is the danger
Perineal tears cause a lot of trouble and pain.
sensations young mom. It can be:
● hematomas and swelling in the suture area;
● failure to urinate;
● inflammation of the sutures with suppuration;
● scar formation on the perineum;
● loss of sensitivity in the area of damage;
● seam divergence;
● disruption of the rectum.
How to avoid
To give birth smoothly and without breaking the perineum, it is necessary
to prepare physically and morally for childbirth. In most
cases of rupture occur when a woman does not listen to an obstetrician. As if
it was not scary, you need to be able not to lose composure and follow
all the doctor’s instructions – he is also interested in a successful outcome
childbirth.
Starting at about 7 months of pregnancy, you need to do a massage.
crotch Also, muscle training (exercise
Kegel): alternation of clenches and relaxations.
Not superfluous, the future mother will attend several classes on
breathing exercises and childbirth relaxation skills.
Conclusion
Breaks during childbirth are quite common. Can they
to avoid? There is no clear answer to this question, but it’s worth
remember that a lot depends on the woman and on how
she is ready to follow all instructions of the doctor.
To avoid breaks, the expectant mother must do everything
possible for its part. First of all, consciously
prepare for the generic process. Be sure to find out how
there is a process of giving birth to a child, where does it start like
breathe properly and relax. The more a woman knows about
the normal course of labor, the more it will be
prepared by.
If, however, it was not possible to avoid ruptures, it is worth knowing that
the risk of developing complications or infections will be high. Required
strictly follow the rules of personal hygiene and seam care. With
the slightest change in the area of the seams – edema, suppuration, pain,
twitching – an urgent need to consult a doctor.
