Preliminary period. This concept includes the presence of irregular, relatively painful contractions in the lower abdomen, accompanied by muscle tension. Such irregular cramping contractions may precede regular labor activity, normally they should not exceed 6-8 hours.
If the preliminary period exceeds 6-8 hours, then it is considered pathological.
Contractions are characterized by:
- certain duration
The main criterion for the course of labor activity is:
- characteristics of the contractions themselves (regular, fairly strong, painful)
- dynamics of opening of the uterine pharynx, in primiparas, the opening of the uterine pharynx is 1 cm per hour, in re-births it is 2 cm per hour.
- Promotion of the head through the birth canal
The main symptoms of the pathological preliminary period
Unlike normal prenatal contractions of the uterus, the pathological preliminary period is characterized by spastic, painful and erratic contractions of the uterus and the absence of structural changes in the cervix, which is a sign of a prenatal violation of its contractile function. The pathological preliminary period can last up to several days. A frequent complication of the pathological preliminary period is untimely discharge within the fetal waters. The main reasons that lead to the development of this complication are: nervous stress; endocrine and metabolic disorders; inflammatory changes in the uterus, the age of the primipara is over 30 years and under 17 years of age.
Treatment of the pathological preliminary period
It should be focused on accelerating the “ripening” of the cervix, removing uncoordinated painful contractions of the uterus. With fatigue and increased irritability, the patient is prescribed medical sleep-rest, soothing products (motherwort tincture, collection of soothing herbs, valerian root); antispasmodics; painkillers; β-mimetics (ginipral, partusisten). For urgent preparation of the cervix for childbirth, products based on prostaglandin E2 are used, which are injected into the cervical canal or posterior vaginal fornix. The duration of treatment of the pathological preliminary period should not exceed 3-5 days. With a “mature” cervix, taking into account a favorable obstetric situation, an early opening of the fetal bladder and conducting labor through the natural birth canal is likely. In the absence of the effect of the therapy,
Prevention of pathological preliminary period
Careful observance of the medical and protective regimen, careful and painless management of childbirth is necessary. Drug prophylaxis is carried out in the presence of risk factors for the development of anomalies in the contractile activity of the uterus: young and old age of primiparas; burdened obstetric and gynecological history; indication of chronic infection; the presence of somatic, neuroendocrine and neuropsychiatric diseases, vegetative-vascular disorders, structural inferiority of the uterus; fetoplacental insufficiency; overstretching of the uterus due to polyhydramnios, multiple pregnancy or large fetus.
Women who are at risk of developing abnormal labor activity will need to undergo physio-psychoprophylactic preparation for childbirth, teach methods of muscle relaxation, control of muscle tone, and skills to reduce increased excitability. Night sleep should be 8-10 hours, daytime rest at least 2-3 hours. Provides a long stay in the fresh air, rational nutrition.