Early childbirth - can be prevented?
Early childbirth also called premature.Most often they are the cause of cervical injury during the previous induced abortion or childbirth abnormal birth canal with a break.Therefore, women with such injuries should be observed as at high risk of preterm birth.
What earlier generations
early or premature birth - a birth at the gestation of 22 to 38 weeks (37 weeks total).Such delivery ends with the birth of a premature baby weighing 500 to 2500 g and a length of 35-45 cm, having the features of functional immaturity.There are spontaneous or induced (caused by artificial means with severe diseases of the mother or fetus), premature birth.If premature births are repeated 2-3 times, then they are called habitual.
rate of premature birth in our country the average is about 6-7%.
Spontaneous early childbirth
reasons for such deliveries may be different.They may be related to genetic constitution or women, its state of the nervous and endocrine systems, a variety of chronic diseases of internal organs (especially the kidneys and cardiovascular system).Has meaning and obstetrical pathology of the pregnancy, for example, cervical incompetence (cervical muscle deficiency, which normally act as a retainer ring, not allowing the fetus to get out of the uterus), acute and chronic infections in pregnant twins, premature detachment of the placenta andplacenta previa, late toxicosis pregnant, fibroids (a benign tumor) of the uterus, genital endometriosis Endometriosis - a serious problem with serious consequences (expansion of areas of the mucous membrane of the uterus in other genital organs, including the muscle layer of the uterus).
Spontaneous preterm delivery occur on the type of emergency (ie, occurring in the term) birth: there is labor, smooths and expansion of the cervix, rupture ofamniotic fluid, the birth of the fetus and placenta.The clinical course distinguish between threatening and went into premature labor.
threatening preterm delivery are characterized by increased tone and irregular uterine activity.There are abdominal pain Abdominal pain: when to sound the alarm? and lower back, sometimes - bleeding Spotting - it is important to rule out pathology from the genital tract, shortening and dilatation of the cervix up to 4 cm. If the initial treatment is ineffective, the threatening preterm labor go to the beginning.
When started preterm delivery appear more intense cramping, smoothing and dilatation of the cervix more than 4 cm. In the future premature births occur as urgent.Duration of delivery is usually greater than urgent, but cervical incompetence marked shortening of the first stage of labor.Characterized as premature discharge of water and bleeding, that occur during the delivery of the placenta (in the third stage of labor).Due to protracted labor and premature discharge of water are often found significant post-natal infection.
Management of spontaneous early delivery
Tactics of treatment for early labor depends on the stage of labor, the intensity of labor, gestational age and viability of the fetus.Conservative expectant management maximize the pregnancy is carried out in the case of a membranes, the satisfactory state of the mother and fetus, the absence of infection, disclosure of uterine throat no more than 2-4 cm, women's lack of serious diseases.
-threatening preterm labor treatment is carried out in a hospital and is in strict bedrest, braking uterine activity and stimulation of the maturation of the lung tissue of the fetus.Inhibition of uterine activity is contraindicated in the death of the fetus, the presence of anomalies in its development, suspected intrauterine infection, bleeding from the birth canal, expressed toxemia of pregnancy, and in some severe diseases not related to pregnancy (eg, infections, diseases of the kidneys).
Stimulation of the maturation of fetal lung tissue is performed using glucocorticoid hormones, which occurs under the influence of maturation of the surfactant - a substance which antagonizes spadenie lung tissue.Such therapy is the prevention of respiratory distress syndrome in infants (distress).
active tactics of delivery - delivery is not delayed and being vaginally - carried out in the case of: opening membranes, regular labor, presence of infection, fetal suffering from lack of oxygen (hypoxia), serious illnesses mothers, polyhydramnios, severe toxemia of pregnancy, suspected fetal abnormalities Fetal development - week after week .
With timely hospitalization of women in the majority of cases it is possible to prevent premature birth, of course, if there are no contraindications.