Childbirth is one of the most important events in every woman's life, but sometimes the birth process can encounter various anomalies. One of these anomalies is weakness, excessive force or incoordination of labor.
Weakness of labor is characterized by insufficient strength and duration of myometrial contractions, increasing pauses between contractions. Primary weakness occurs at the beginning of labor and can continue both in the II and III stages of labor. Secondary weakness develops against the background of normal contractions in the first or second stage of labor. The causes of primary weakness of labor may be associated with overstrain of the central nervous system, endocrinopathies, metabolic disorders, malformations of the uterus, inflammatory processes in the genitals, etc. The development of primary weakness of contractions is facilitated by prenatal rupture of amniotic fluid.
Excessive labor activity is caused by uterine hypertonicity and is clinically expressed by very frequent contractions with shortened intervals between them. Childbirth ends quickly (rapidly), with uteroplacental circulation disorder and fetal hypoxia occurring.
Discoordinated labor is characterized by unsystematic contraction of parts of the uterus (fundus and lower segment). Contractions are regular, but very painful and ineffective; opening of the pharynx occurs slowly, despite the absence of signs of rigidity. There is no advancement of the presenting part of the fetus, spontaneous urination is impaired, although there are no signs of bladder compression.
Anomalies of labor can lead to a protracted course of labor, fetal hypoxia, the development of an ascending infection (chorioamnionitis), bleeding in the postpartum and early postpartum periods and an increased incidence of postpartum diseases.
The diagnosis of anomalies of labor is made on the basis of dynamic observation of the nature of labor, determined during vaginal examination, using cardiotocography, external hysterography and other research methods.
Treatment of labor anomalies is determined by the woman’s condition. For mild forms, methods of non-pharmacological correction of labor are used, such as changing the position of the woman’s body, uterine massage, using hot compresses, etc. In more severe cases, the use of medications such as oxytocin, magnesium sulfate and other drugs may be required.
In some cases, surgical delivery, such as a caesarean section or vacuum extraction, may be required. However, the need for surgical intervention should be assessed individually and only if there are vital indications.
In general, labor anomalies are a serious problem that can lead to adverse consequences for mother and child. Therefore, it is important to promptly identify abnormalities in labor and apply appropriate measures to correct them.