Circular dystopia of the uterus (contraction ring)

Circular dystopia of the uterus (contraction ring) - pathology, which is due to contractions of the circular muscle fibers at different levels of the uterus (except the cervix). Circular dystocia of the uterus is encountered during prolonged births with long-discharged waters. It is noted that the uterus covers the fetus around the neck or abdomen. The cause may be increased excitability of the uterus. This pathological condition occurs both in the first and second stages of labor.

Symptoms. The mothers usually complain of severe pain in the uterine region, localized in the area of the contraction ring and above it. Visually, one can see a constriction on the uterus in the area of the contraction ring. Palpation - ring-shaped retraction on the uterus. During the fight, the fetal head can be easily moved from side to side. Disclosure of the cervix is slow or stops. Often there is a premature discharge of amniotic fluid. The birth takes a protracted character, the suffering of the intrauterine fetus is noted.

With vaginal examination, the fetal part does not move forward during the bout (in the absence of signs of mismatch). Part of the uterus between the external throat and the contraction ring is passive during the contraction. The diagnosis of this pathology can be confirmed by examining the uterus during a caesarean section - a constriction on the uterus. Undoubted help in the diagnosis of this anomaly of labor can have an ultrasound.

Differential diagnosis should be carried out primarily with a mismatch between the fetal head and the mother's pelvis, with secondary weakness of labor, as well as cervical dystocia. Dystocia of the cervix should be attributed to anomalies of the maternal pathways, and not to abnormalities of labor. The presence of dystocia of the cervix usually leads to abnormalities of labor.

In the absence of a threatening condition on the part of the mother and fetus , tocolysis with beta-adrenomimetics (partus, bricanil, ritodrin, etc.), the introduction of spasmolytic agents (no-spawn 2 ml, baralgin 2 ml, etc.) is shown. You can enter an intramuscular 25% solution of magnesium sulfate 10 ml, subcutaneously pantopone (2% solution - 1 ml), promedol (1% solution - 1 ml), seduxen (10 mg). If the effect could not be achieved, to eliminate the contraction ring, one should resort to deep anesthesia with ether, fluorotan.

Obstetric forceps can only be applied under deep anesthesia with ether or fluorotane and if there are conditions for their application. At a dead fruit spend fruit-destroying operation, sometimes it is necessary to resort and to operation of cesarean section. The operation of caesarean section in case of lack of success from drug therapy, including deep anesthesia, is the method of choice. For the purpose of careful extraction of the child, it is advisable to make a longitudinal incision on the uterus.

[1], [2], [3], [4], [5]