Weakness of labor: causes, consequences, forecasts

This article will address the issue of weakness in labor. We will tell you in detail about the causes, symptoms, consequences and resolution of childbirth.

To denote what it is. Weakness of labor is insufficient activity of the uterus. That is, labor is difficult and time-consuming, since the uterus is poorly contracted, the cervix is difficult to open and the fetus is very slow and difficult. Childbirth does not always go well, as it should, there are anomalies of labor. You will learn about one of them in great detail from this article.

Weakness of labor

However sad it might sound, anomalies of labor activity are quite common. The reasons for this phenomenon are quite numerous. Now we will talk about the weakness of the generic process.

This is one of the possible violations of labor. With this diagnosis, the contractile function of the uterus, which is necessary for expelling the fetus, is weakened. This is due to:

• Low tonus of myometrium;
• Rare contractions;
• Weak amplitude of contractions;
• Prevalence of diastole;
• The period of reductions considerably lags behind the period of relaxation;
• Delayed opening of the cervix;
• Slow progress of the fetus.

More details will be presented in another section. Now give some statistics. This diagnosis in obstetrics and gynecology is the most popular, as this is a very frequent complication of childbirth and the cause of various pathologies of both mother and child. Statistics argue that more than seven percent of births are complicated by the weakness of labor. And one more fact: this diagnosis is established more often by women who give birth to the first child. As a rule, subsequent births take place without any difficulties, but there are cases of diagnosing the weakness of labor and in subsequent births.

Causes

We explained what the weakness of labor is. Many factors can serve as the reasons. We propose to list them. The causes of weakness of labor can be:

• Morphological inferiority of the uterus;
• Insufficiency of hormonal regulation of the birth process;
• Functional inertness of nerve structures;
• Extragenital diseases;
• Hypoplasia;
• myoma;
• Chronic endometritis;
• Adenomyosis;
• Bicornuate uterus;
• Saddle uterus;
• Medabort;
• Scraping;
• Conservative myomectomy;
• Scars after treatment of cervical erosion (if a woman has not previously given birth).

There are some other reasons. Weakness of the ancestral forces can arise due to a violation of the balance of factors that affect the generic activity. The positive factors include the following:

• Prostaglandins;
• Estrogens;
• Oxytocin;
• calcium;
• Mediators and so on.

Negatively affect:

• progesterone;
• magnesium;
• Enzymes that destroy mediators and others.

It is very important to note that women suffering from certain disorders (vegetative-metabolic) often face this problem during childbirth. Such violations include:

• obesity;
• Hypothyroidism;
• Hypofunction of the adrenal cortex;
• Hypothalamic syndrome.

The age of the first-born also has a great influence. If the girl is very young or her age is more than 35 years, the labor activity may be difficult. It is also important and the term at which the birth activity began. The weakness of the uterus can be the cause of a delayed pregnancy or premature.

If pregnancy is prolific, then this pathology is possible during childbirth. With multiple pregnancies, the uterus overgrows. Overexpression can also occur with a large fetus or polyhydramnios.

Often, with the difficulty of labor, miniature girls come into contact, since the narrow pelvis also causes the uterus to work poorly. The reason is a disproportion between the size of the child and the pelvis of the woman.

The reasons are still very numerous, unfortunately, everything can not be listed. Now we will highlight some more popular ones:

• overwork;
• Mental stress;
• physical exercise;
• Poor nutrition;
• lack of sleep;
• Fear of childbirth;
• discomfort;
• Poor maternity care and so on.

Thus, you can classify all the reasons as follows:

• On the part of the mother;
• Complications of pregnancy;
• From the side of the child.

Kinds

The weakness of labor can occur absolutely at any stage of labor. In connection with this, it is customary to identify certain types of weakness:

• Primary;
• Secondary;
• Weak attempts.

We suggest a little more detailed consideration of each species separately.

The primary weakness of labor is characterized by inactive fights in the first period of labor. They are very weak, short and not rhythmic at all. It is important to note that with a primary weakness, an understated tone of the uterus (less than 100 mm Hg) is seen. At this stage, a woman is able to diagnose the problem herself. How can this be done? Ten minutes and count the number of fights for this period. If the number does not exceed two and you practically do not feel them, the diagnosis was confirmed. You can measure the time of one contraction, it should be more than 20 seconds in the absence of weakness of labor activity. Diastole, or rest period, while elongated almost twice. How can tangibles affect the problem? It's simple, if they are painless or painless, then pressure from the uterus is not enough to open the neck.

Secondary weakness of labor is characterized by a weakening of the intensity of the uterus. Before this fight could be normal. The causes of development are the same as in the case of primary weakness of the ancestral forces. Another indicator is the progression of the opening of the uterine throat. If progress is not visible after five to six centimeters of exposure, then we can confidently talk about secondary hypotonic dysfunction of the uterus.

If primary and secondary weakness is observed in ten percent of cases of adverse childbirth and is characteristic of primiparas, then the weakness of the exacerbation period is extremely rare (two percent of all cases of severe births), and is typical for multifaceted women or for obesity.

Symptoms

Symptoms of primary weakness of labor are:

• Decreased excitability of the uterus;
• Decreased uterine tone;
• Reduced frequency of contractions (up to two in ten minutes);
• Short duration of contractions (up to twenty seconds);
• The force of contractions does not exceed 25 mm Hg. P.
• Short period of reduction;
• Extended period of rest;
• There is 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 total time of childbirth. This, in turn, badly affects the mother and the baby. The woman in labor is greatly overworked, possibly early expulsion of water.

Symptoms of secondary weakness:

• A weakening of the intensity of contractions (perhaps even a complete cessation of them);
• Weakening of tone;
• Decreased excitability;
• There is no progression of the opening of the uterine throat;
• Stop fetal progression through the birth canal.

This is no less dangerous than the primary weakness. The child may develop asphyxia, or he may die. For the mother, it is dangerous to the probability of infection of the uterus, birth trauma. Prolonged standing of the baby's head in the birth canal can lead to the formation of bruising or fistula.

Diagnostics

In this section, we will discuss diagnosing the problem of weakness (primary and secondary) labor. The diagnosis of primary weakness is based on the following:

• Decreased uterine activity;
• Reduced rate of smoothing of the cervix;
• Delayed opening of the uterine throat;
• Long standing of the fetus;
• Increased delivery time.

It is important to note that the partogram (or graphic description of genera) has a great influence on the diagnosis. This diagram indicates everything:

• Neck opening;
• Promotion of the fetus;
• pulse;
• pressure;
• Baby's palpitations;
• Contractions and so on.

If there is no progress in the disclosure of the cervix for two hours, which is clearly represented in the partogram, then this diagnosis is made.

Diagnosis of secondary weakness is based on these indicators:

• Partogram;
• CTG;
• Listening to the heartbeat.

This is necessary so that the fetus does not develop hypoxia. There are some complications of the generic process, which are symptomatically similar to weakened labor. These include:

• Pathology of the preliminaries;
• Discordance of labor;
• Clinically narrow pelvis.

Treatment

It is important to note that the treatment is selected individually for each woman in labor. At treatment the doctor should consider all the data that he has (the condition of a woman and a baby).

A good remedy for weak labor is the technique of drug sleep. For this purpose, special medications are introduced so that the woman rests, then the labor activity may intensify.

If this did not help, then they resort to a puncture of the fetal bladder. After this procedure, labor activity becomes much more intensive. It is worth noting that the puncture is carried out only if the cervix is ready.

Sometimes doctors resort to drug stimulation. Now we will briefly consider the drug Miuropriston for the stimulation of childbirth. This drug should be taken strictly under the supervision of doctors. It inhibits progesterone, which has a beneficial effect on the contractile activity of the uterus.

Delivery

If no methods have helped, including Miuropriston for the stimulation of labor, the doctor can perform an emergency caesarean section. What methods are performed before the operation:

• Medication sleep;
• Amniotomy;
• Drug stimulation.

In addition, there may be additional indications for the operation. There is some list of contraindications to the stimulation of labor (a narrow pelvis, scars on the uterus, a threat to life and so on).

Prevention

We examined in detail the issue of the weakness of labor. Clinical recommendations for prevention can be given by an obstetrician-gynecologist who leads your pregnancy. He should talk about possible complications during childbirth and conduct physical and psychological training of the woman in childbirth. In addition to rhodostimulation, the prevention of possible complications in the fetus is mandatory.

Effects

What are the complications of the weakness of labor? For the mother, this can be:

• Formation of hematomas;
• Fistula formation;
• Possible infection.

The following complications are possible for the child:

• Hypoxia;
• acidosis;
• Edema of the brain;
• death.

Everything depends on the professionalism of the doctor. With proper stimulation and precise control of the condition of the child and mother, there should be no consequences.

Forecast

Now, briefly about predicting the weakness of labor. As mentioned earlier, everything 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 difficult labor are rare.

Continuous delivery

Weakness of labor at the first birth does not mean that all the following will proceed in a similar way. Primary and secondary weakness is common in women who give birth to the first-born. A small percentage of mnogogorozhavshih may be noted weakness of the excruciating period.