Pregnancy

Pregnancy shifted. Continuation of pregnancy more than 41-42 weeks. There are true perenashivanie (pathological state) and imaginary pererashivanie. In midwifery practice, the greatest importance is true peresashivanie, whose frequency is 10%. Reasons for overstraining are not well understood. These include functional changes in the central nervous system, endocrine disorders, decreased excitability of the uterus, pathological changes in the fetus.

Symptoms, course. The delayed pregnancy is characterized by the absence of labor after the expiration of the anticipated term of childbirth, the absence of a rise in the body weight of the pregnant woman, a decrease in the circumference of the abdomen by 5-10 cm due to resorption of amniotic fluid, large fetal dimensions, dense bones of the skull, changes in the cardiac activity of the fetus (chronic hypoxia, ECG). In amnioscoli, an admixture of meconium is found in the amniotic fluid. In the study of amniotic fluid obtained by amniocentesis, a decrease in the glucose concentration to 0.1 g / l and less (at a rate of 0.2-0.5 g / l) is observed. The content in the urine of estriol is reduced. In the cytological examination of the vaginal smear, a large number of intermediate cells and the absence of keratinizing cells are determined. The fetus is in an endangered state during perenashivanii (often intrauterine hypoxia and fetal death are observed). In childbirth there is a danger of intracranial hemorrhages and asphyxia.

Treatment consists in excitation of patrimonial activity by medicamentous means after preliminary creation of a glucose-calcium-hormonal background. To this end, administer oxytocin IV droplet 5 units in 500 ml of 5% glucose solution, starting with 6-8 drops and bringing up to 40 drops per minute, or 5 mg of prostaglandin F2alpha in 500 ml of isotonic sodium chloride solution, or 2, 5 mg of prostaglandin F2alpha and 2.5 units of oxytocin in the same solution. The rate of administration is from 6 to 20-30 drops per minute. A pregnant pregnancy combined with other complications (elderly age of the primipara, narrow pelvis, pelvic presentation of the fetus, etc.) can serve as an indication for the caesarean section.