Features of rapid childbirth

What pregnant woman does not dream of giving birth as soon as possible? But this is only a seemingly fast generic process - a blessing. On closer inspection, a quick birth can be very dangerous for both the woman and her baby. Fast is not always good, and even more so for childbirth. In this article, we will talk about what rapid childbirth is, what is the danger and how to prevent it.

What it is?

Childbirth is considered the most favorable in which the baby goes through each of the stages of the birth canal gradually. Finding himself in one or another part of them, he manages to adapt to new conditions, which significantly reduces the risks of getting a tiny birth trauma, many of which can be very dangerous.

Normally, in primiparous women, childbirth can last 12 and 14 hours, and in women who give birth again - 8-10 hours. The duration of the labor process up to 18 hours is not considered abnormal and protracted. If, for some reason, the birth process begins to proceed faster than nature intended for a better adaptation of the baby, doctors talk about rapid and rapid childbirth.

Fast and impetuous in the understanding of obstetricians are not the same thing. The International Classification of Diseases (ICD) clearly distinguishes these types of abnormal labor into separate ones. Childbirth is called rapid delivery, which lasts a total of up to 4 hours. If a woman gives birth to her first child, then her rapid labor lasts no more than 4 hours (for multiparous children - 2 hours). If the primiparous patient gives birth in 4-6 hours, then they talk about rapid labor.

At the physiological level, there are fast and intense contractions. They are dangerous in that the risk of injury to the child and the genital tract of the mother increases. With such intense contractions, the tissues of the uterus are overexcited, and the pressure inside its cavity increases significantly. In such extreme conditions, a convulsive state of the myometrium sometimes develops, which may well lead to rupture of the genital organ.

Despite the fact that the ICD still divides the concepts of "fast" and "impetuous", the difference between them is only 1 hour, and therefore quite often even medical workers use them as synonyms. It should be noted that Rapid childbirth is infrequent - according to existing medical statistics, they account for no more than 0.4-2% of all urgent deliveries.

Such births are pathological because they contradict natural mechanisms. Quite often, they are accompanied by ruptures of the vagina, cervix, massive and life-threatening bleeding for a woman, and divergence of the pelvic bones. Often the placenta exfoliates ahead of schedule in rapid and rapid labor, which leads to the development of severe bleeding, as well as acute hypoxia in the child, which can cause his disability or death. Birth trauma is a significant percentage of complications.

The faster the delivery proceeds, the higher the likelihood of negative complications.

Why is this happening?

The reasons that can lead to the development of rapid and rapid labor activity are numerous. The factors that contribute to such a pathological course of the generic process may lie in different areas.

Most often, the reason lies in the increased excitability of the myometrium - uterine tissue. Its increased reaction to hormones that stimulate contractions, and starts the process of overexcitation. This property of the myometrium may well be inherited by a woman from her own mother or grandmother, and can also be acquired.

Often the reason lies in the increased production of oxytocin, when this hormone, produced by the placenta and pituitary gland, is synthesized in the body more than is needed to ensure normal and measured labor pains.

A one-time outpouring of a large amount of amniotic fluid increases the likelihood that a woman will give birth quickly. When outpouring, a huge amount of active substances is released, which enhance and accelerate the process of the baby's birth.

Not so long ago, it was a pernicious practice in maternity hospitals to stimulate almost every childbirth with medication. At the same time, they were not very perplexed by the presence of strict indications for the induction of labor, but simply punctured the fetal bladder at the right time and began to inject oxytocin. Today, such induction without evidence has been abandoned, since it was inept and unreasonable stimulation that often became the cause of rapid and impetuous childbirth with all the aggravating consequences.

Doctors have noticed that most often rapid and rapid childbirth occurs in women who are distinguished by an unstable psyche, suffer from neuroses, hysteria, are prone to depression, and sharp changes in the emotional background. The following reasons also increase the likelihood of such a pregnancy outcome:

adrenal ailments;
diseases of the thyroid gland in a pregnant woman;
inflammatory and infectious diseases of the genitourinary system.

It should be noted that doctors have been studying the causes of rapid childbirth for a long time. Long-term studies of Russian and foreign specialists have shown that the risk group includes:

patients with a burdened obstetric history, in particular, previous injuries to the reproductive organs, operations on the uterus, as well as severe ruptures in previous births;
women who previously gave birth to dead babies;
pregnant women who have already carried and given birth to three or more children, and now are carrying a subsequent baby;
women with diagnosed ischemic-cervical insufficiency during the current pregnancy;
ladies with a wide pelvis;
patients who are carrying, according to preliminary estimates of ultrasound, a small in size and weight child;
patients who have already had rapid labor earlier;
girls who become pregnant before the age of 18 and older pregnant women who are more than 36 years old at the time of the onset of the "interesting situation".

The risk that you will have to give birth rapidly exists in pregnant women with hypertension, heart and vascular diseases, and anemia. Among the likely factors of negative influence, pathologies such as polyhydramnios, a large fetus, pregnancy with twins or triplets, late toxicosis in a woman, Rh-conflict between the mother and the fetus are indicated. Disputes about the degree of influence of certain reasons are still going on. But in general, scientists and doctors of all countries agree that the main reason for such pathological childbirth is disruption of the nervous system. That is, the brain mistakenly accepts afferent impulses coming to it from the receptors of the uterus.

As a result, labor becomes abnormal. And the reasons that can disrupt the reception of impulses are just hidden in the factors listed above. Most often, it is not possible to establish the true root cause.

How do they proceed?

Any childbirth consists of three periods, which successively replace each other. In the first period, the cervix is dilated. When it expands to a maximum of 10-12 centimeters, the second period begins - a hard one. In the course of attempts, a baby is born. In the third period, the placenta comes out.

With normal urgent (that is, occurring within normal terms) childbirth, the first period is the longest - about two-thirds of the entire labor time is spent on labor. The intensity, strength and duration of contractions increases smoothly and gradually. The second period in normal childbirth also proceeds smoothly and ends with the birth of a child. The labor ends with the release of the remnants of the membranes and the "child's place". The total duration of the three periods can be 10, 12, or more hours.

With rapid delivery, the flow options may be different. If the birth was spontaneous and caused them, presumably, by uterine factors (a stretched neck, weak muscles due to multiple births or for other reasons), then already in the first period the contractions intensify very quickly and repeat after an hour and a half more than 3 times for every five minutes of time.

It is noteworthy that spontaneous childbirth rarely leads to female injuries - together with the cervix, which opens abnormally quickly, the birth canal also has less resistance. Due to this, ruptures occur infrequently. But for a child, such childbirth is quite dangerous, especially if the baby is large.

Another unfavorable scenario is spastic labor. This is a quick birth, which occurs against the background of an increase in the frequency of contractions - within half an hour after the onset of labor, a woman can celebrate one contraction every 2 minutes. The contractions themselves are very painful, protracted, long, rest periods are minimal, the woman quickly gets tired, worried, and nervous. Very often, blood pressure rises, heart rate increases, vomiting and nausea appear. Water is usually poured out almost in full and ahead of schedule. The forecasts for the woman and the child are less favorable.

During spastic childbirth, the placenta often exfoliates, bleeding develops, the child receives injuries to the head and cervical spine, and he has cerebral hemorrhages, which may have irreversible consequences in the future. A child is usually born in just a couple of attempts.

There is another scenario for the development of events in the hospital. It is called a rapid birth. This is essentially a rapid delivery, which begins and in its first period proceeds as usual, uncomplicated, but the time balance between the first and second periods changes. That is, the attempts last less than the norm and instead of one and a half to two hours they are only a few minutes. Most often, this happens with a low fetal body weight, its pronounced hypotrophy, for example, against the background of a severe severe Rh conflict or chronic hypoxia, as well as in women with a wide pelvis.

A woman has a high risk of lacerations and injuries, but a child has an even higher risk of brain and spinal cord injury.

Possible consequences

As it has already become clear, for a woman, the main risk lies in the likelihood of injury to the genital tract, perineum, cervix, uterine body. At the same time, rupture of the uterus is the most dangerous consequence that directly threatens the life of the woman in labor. If this happens, an operation is urgently performed to remove the reproductive organ.

In the early postpartum period, women who gave birth quickly and rapidly often have problems with the production of breast milk, with the establishment of lactation. More often than other women in childbirth, such mothers experience blockages of the milk passages and mastitis.

But no matter how dangerous all this is for a woman, the consequences for a child can be much more severe.

Abnormal contractions leave no chance for normal placental blood flow, and therefore, already during the period of contractions, the child develops hypoxia. In severe cases, the brain suffers from oxygen starvation, and with a rapid birth through the birth canal, suffocation can occur due to a critical lack of oxygen.

Very often, babies born quickly or quickly have different size and location of brain hematomas, hemorrhages in different internal organs. Rapid and uncompensated passage through the birth canal often leads to fractures of the clavicle, humerus, spine in the cervical spine. Damage to the brain and the entire central nervous system can be total, that is, they are not subject to reverse development, and they respond poorly, if at all, to treatment.

What do doctors do?

Unfortunately, at the beginning of rapid labor, it is very difficult to get to the hospital on time, so most women arrive late, which increases the risk of complications and worsens the overall prognosis for the mother and fetus. Therefore, it is accepted that women from the risk group are hospitalized in advance if they suspect a possible start of rapid labor. If labor begins, it will be better when it proceeds initially under the supervision of doctors.

Upon admission to the maternity hospital, doctors are trying to normalize the nature of the birth process. A cleansing enema is contraindicated in this case, and walking around the ward is also contraindicated. The woman moves only by the medical staff on a special gurney and lies on her side, which is opposite to the position of the child in the womb.

In some cases, tocolytic drugs, which are administered intravenously to a woman lying on a bed, help to reduce the intensity of contractions. If a woman is hypertensive, then instead of contraindicated tocolytics, calcium antagonists are administered to her. If the pain during labor is severe, an epidural may be used.

A woman gives birth in a position on her side. Only the afterbirth period passes in the usual position - lying on the back with the thighs apart.

If the intensity of contractions does not decrease, despite the measures taken, while there is a threat of uterine rupture or placental abruption begins, an emergency caesarean section is performed. The operation is also carried out in case of detection of acute hypoxia in the baby.

At any stage of rapid delivery, there may be a need for blood transfusion, and therefore it is prepared from the moment a woman enters the hospital. The resuscitation team is also prepared in advance, since most children, after a hasty birth, require urgent resuscitation care.

Prevention

The most effective prevention of rapid childbirth is the doctor's awareness of the health of the pregnant woman and the woman's awareness of the possible consequences. Therefore, it is important not to hide anything from the doctor, to attend scheduled appointments in a consultation in a timely manner, to follow and follow all the doctor's recommendations, especially if the woman is in the so-called high-risk group.

It is better for pregnant women of this group not to plan travels and trips far from home during the period of carrying a child, because rapid childbirth is often called "street", since it can begin without preconditions, suddenly.