Rapid birth
Last reviewed: 23.04.2024
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Definition. According to the definition of E. Friedman (1978), the 95th percentile for the rate of cervical dilatation corresponds to 6.8 cm / h in the primipara and 14.7 cm / h in maternity females.
For the speed of lowering the present part of the fetus, these boundaries are respectively equal to 6.4 and 14.0 cm. Therefore, for practical purposes, it should be considered that rapid delivery (not to be confused with a rapid birth) is characterized by the rate of opening the cervix and lowering the presenting part of the fetus, exceeding 5 cm / h in primiparas and 10 cm / h in the miscreant. In most cases, the rapid opening of the cervix and the rapid lowering of the fetus are simultaneously occurring.
Diagnostics. Usually, the diagnosis of rapid delivery is retrospectively when analyzing the flow curve of labor.
Causes. Etiological factors leading to the development of this complication are unclear. With this impairment of labor, the trigger mechanism can be the stimulation of fights with oxytocin, although in a large series of studies only 11.1% of women with impetuous labor were treated with oxytocin.
Forecast. The prognosis for vaginal delivery is good. Sometimes births are too fast, which leads to the birth of the fetus right in bed. After delivery, the midwife should carefully examine the cervix to identify possible gaps, often observed with rapid delivery.
A prognosis for the fetus and newborn should be stated with caution. Often the fetus can not tolerate hypoxia, caused by frequent and powerful contractions of the uterus. As a result, this leads to the development of a threatening condition of the fetus during labor, oppression of the newborn's life and to the disease of hyaline membranes.
Prevention of abnormalities of labor should begin long before delivery. It is important to implement activities for hygiene of childhood and school age (rational diet, exercise), providing harmonious development of the female body. During pregnancy, the implementation of hygiene measures, adequate nutrition, in the second half of pregnancy - wearing a bandage. Pregnant women need a full course of physiopsycho- prophylactic preparation for childbirth, the appointment of vitamins.
All pregnant women classified as at risk of developing anomalies of labor should be hospitalized in advance to the department of pregnancy pathology, not later than 38 weeks. Since the 38th week of pregnancy, a comprehensive preparation for childbirth is prescribed. If the cervix remains unripe after a 2-week comprehensive preparation for childbirth by the 40th-41st week of pregnancy, the birth plan should be reviewed in favor of delivery by a caesarean section, taking into account the complicating factors on the basis of which the pregnant woman was included in the risk group for anomalies of labor.
Conducting rapid delivery
In the diagnosis of rapid delivery before the birth of the fetus, especially if there are signs of distress (suffering) in monitoring the fetus, it is necessary to stop the development of labor by using beta-adrenomimetic drugs. Terbutaline (0.00025-0.0005 g intravenously) or ritodrin (0.0003 g / min intravenously) are effective agents leading to a reduction in the frequency, duration and strength of uterine contractions.
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