INVENTION
Russian Federation Patent RU2007166

METHOD RODOSTIMULYATSII

METHOD RODOSTIMULYATSII

Name of the inventor: Kulikova IK .; Daffodils RP
The name of the patentee: Kulikova Irina Konstantinova
Address for correspondence:
Starting date of the patent: 1991.01.24

Use: in obstetrics. The aim of the invention is to accelerate the completion of the II stage of labor and reduce the frequency of operative delivery, prevention of complications in the newborn. SUMMARY ways: intravenously administered oxytocin intravenously and a 40% glucose solution 15 ml for each preparation: 0.1 kokarboksilazu, lime acid a 0.5% 4 ml Calcium pantothenate 20% and 2 ml intramuscularly riboflavin mononucleotide 1%.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, namely to obstetrics.

The aim of the invention is to accelerate the completion of the II stage of labor and reduce the frequency of operative delivery and the prevention of complications in the newborn.

The process is as follows. Maternity administered intravenously by oxytocin (5 U) at the 5% glucose solution (500 ml) after intravenous administration of sequential cocarboxylase 0.1, 0.5% lipoic acid, 4,0, 20% Calcium pantogenata, 2.0, 40% glucose solution (15 ml for each drug) 1% 1.0 riboflavin mononucleotide intramuscularly.

EXAMPLES EXAMPLE 1. Diagnosis: Pregnancy III, 38 weeks. I. Prenatal Childbirth outpouring water. Anemia II degree. Chronic intrauterine fetal hypoxia.

On admission - no regular labor.

Started creating VGGK, background, after which developed regular labors. Contractions 5-6 minutes 25 seconds.

After 6 hours, re-inspected. Contractions weak after 5 minutes for 25-30 seconds. Vaginal examination: cervix flattened to 0.5 cm, rather compact. The opening of the cervix 3-4 cm. Membranes does not. Predlezhit head pressed against the entrance to the pelvis. The Cape is not reachable. Bone ring without deformation.

It was decided to continue to maintain a conservative labor. The not mentioned during the following 6 hours of dynamic amplification of labor. At vaginal examination the cervix is ​​smoothed, rather compact. The opening of the cervix 5-6 cm. Membranes does not. Predlezhit head pressed to the entrance of the pelvis.

Diagnosis: Pregnancy III, 38 weeks. I. Prenatal Childbirth outpouring water. I uterine inertia. Anemia II degree. Chronic intrauterine fetal hypoxia.

Started rodostimulyatsiya oksitopinom in conjunction with co-factors of energy metabolism. After 15 min of contractions rodostimulyatsii 2-3 min at 60. At 22 h 45 min 25.09.1990, there was a fixed-term labor hypotrophic boy weighing 2450 g, length 49 cm. Evaluation of Apgar score 8-9. The postpartum period was normal. Total blood loss during childbirth 200 ml. The total duration of delivery 15 hours (one before the rodostimulyatsii 12 hours after 3 hours rodostimulyatsii).

The postpartum period was uneventful. The woman was discharged home with your child on the 8th day post-partum period.

EXAMPLE Example 2. Woman in labor Ya, '21 Pregnancy I, 41-42 weeks. Genera I. The pathological preliminary period. Anemia I degree. Chronic intrauterine fetal hypoxia. Colpitis.

On admission - no regular labor. Start creating VGGK-background. Considering fatigue mothers, she provided medical juice.

The appearance of the fights. These vaginal examination: vagina narrower. Cervical softening consistency, up to 1 cm. The opening of the cervix 2-3 cm. The bag of water intact, is filled with struggle. Predlezhit head pressed to the entrance of the pelvis. The Cape is not reachable. Bone ring without deformation.

At follow-up for giving birth were observed for 12 hours, strengthening labor. When vaginal study found the rate of cervical dilatation slowing down (for 12 hours after the start of regular labor uterus opened up to 4-5 cm).

Diagnosis: the same + I uterine inertia.

Rodostimulyatsiyu carried intravenous drip of oxytocin in combination of energy metabolism (cocarboxylase 0,1% Lipoic acid 0.5 4.0 Calcium pantogenatom intravenously 40% glucose solution, 1% riboflavin mononucleotide 1.0 intramuscularly). After 15 minutes from the start of the bout rodostimulyatsii frequent and become more Duration: 3 min 50 sec.

There has been a belated birth girl weighing 3100 g, length 52 cm, with 1-fold loosely around the neck cord entanglement. Evaluation of Apgar score 8/8.

Postpartum period was physiologically. Total blood loss during childbirth 250 ml.

The total duration of delivery 15 h 45 min of them rodostimulyatsii 12 h 30 min, after rodostimulyatsii 3 h 15 min.

Postpartum uneventful. The woman was discharged home with your child on the 6th day post-partum period.

Example 3. Woman in labor D., 22 years old. Diagnosis: Pregnancy II, 40 weeks. Childbirth II. I stage of labor. Preeclampsia mild. Anemia I degree. Chronic intrauterine fetal hypoxia. Regional State Administration.

When a regular labors, fights in 3-4 minutes at 40-45 with. When vaginal study: the vagina capacious. The cervix is ​​soft, shortened to 0.7 cm. The opening of the cervix 3-4 cm. The bag of water intact. Predlezhit head over the entrance to a small basin. The Cape is not reachable. Bone ring without deformation.

Poured out water, due to which a woman in labor re-examined. Contractions become rare, 4-5 minutes, the duration of their decreased to 25-30 seconds. When vaginal study: full opening of the cervix. No membranes. Predlezhit head on I pelvic plane. Sagittal suture in the transverse size of the pelvis. Small fontanelle on the left side. Obstacles for the expulsion of the fetus from the pelvic bone there.

Diagnosis: the same + the beginning of the II stage of labor.

The not mentioned during the next 2 hours observing giving birth strengthening labor. At external examination, promotion head in the pelvic cavity is not detected, and therefore the woman re-examined vaginally: full opening of the cervix. Predlezhit head at the II pelvic plane. Sagittal suture in the transverse size of the pelvis. Small fontanelle on the left side. Obstacles for the expulsion of the fetus from the pelvic bone there.

Diagnosis: the same + uterine inertia.

Rodostimulyatsiya initiated intravenous drip of oxytocin in combination with cofactors energy metabolism (cocarboxylase, lipoic acid, calcium intravenously pantogenatom 40% glucose solution, riboflavin - mononucleotide intramuscularly). After 10 minutes after the start of rodostimulyatsii contractions intensified and frequent (2-3 min 60 sec).

There were attempts (2-3 min 60 sec).

Born live full-term girl weighing 3800 g length 54 cm.

Apgar score 8-9.

The postpartum period was physiologically. Total blood loss during childbirth 200 ml.

The total duration of delivery 10 h 35 min (one to rodostimulyatsii 9 h 45 min, after rodostimulyatsii - 50 min).

The postpartum period was uneventful. Puerperas discharged home with your child on the 5th day after birth.

The proposed method rodostimulyatsii tested in 15 women with uterine inertia I and II 10 women with uterine inertia (in the bearing-down period) due to iron deficiency anemia (I-III degree). Group comparisons were 20 women with uterine inertia I and II 10 women with uterine inertia (in the bearing-down period) due to anemia who underwent rodostimulyatsiya prototype.

The course and outcome of childbirth for mother and fetus are presented in Table. 1-4. As can be seen from Table. 1, although the establishment of the same frequency for both contractions rodostimulyatsii methods, the duration of each contractions when stimulated by the proposed method was 1.5-2 times higher than in the control group. Duration of delivery after starting rodostimulyatsii in maternal band stimulated by the proposed method, was significantly less than in the prototype rodostimulyatsii (P 0.05). In the group of women in labor, stimulated by the proposed method, the frequency of cesarean delivery was 3 times lower than in the comparison group, but did not take any recourse once the imposition of obstetric forceps. Status of newborns from mothers stimulated by the proposed method (.. See Table 2) at birth it was much better than in the comparison group: among the first was 2 times less than children born in asphyxia of varying severity than in the past.

A similar positive effect was observed during rodostimulyatsii proposed method in women with II uterine inertia (in the bearing-down period) (see Table 3..), Along with an increase in labor duration in patients, stimulated by the proposed method, it was noted a decrease in the duration of labor, compared to Pregnant Women stimulated the prototype.

birth outcomes for mother and was favorable: in a group of pregnant women, stimulated by the proposed method has never had to resort to operating methods of delivery, whereas in comparison it was required in 30 cases. Mothers, stimulated by the proposed method, the children were born in a state of asphyxia of varying severity is 2.5 times less than in the comparison group (see. Table. 4).

Thus the positive effect of the proposed method, in contrast to the prototype is to accelerate childbirth 2 times after the start of rodostimulyatsy in obstetric patients with weakness of labor is not against anemia. Also when using the proposed method rodostimulyatsii operative delivery in women with a weakness I labor against the background of anemia decreased by 4 times, and in women with uterine inertia II - 30 times. A corresponding reduction in the incidence of neonatal asphyxia (2 and 2.5 times) was observed in children of mothers stimulated with the proposed method, compared with the prototype rodostimulyatsiey.

Thus, the proposed holding rodostimulyatsii in women with iron deficiency anemia, including intravenous drip of oxytocin with the additional introduction of complex cofactors energy metabolism, activating production makroenergicheskih compounds (ATP) in the uterus, provides a higher positive effect is to accelerate act of birth after the start of rodostimulyatsii and a more favorable outcome for the birth mother and the fetus (reductions in operational permits mothers and asphyxia in newborns). (56) Bodyazhina VI et al. Obstetrics. M.: 1986, p. 321.

CLAIM

METHOD RODOSTIMULYATSII comprising oxytocin intravenous drip, characterized in that, in order to accelerate the completion of II stage of labor and reduce the frequency of operative delivery and prevention of complications of newborn administered sequentially kokarboksilazu 1.0, 5% solution of lipoic acid and 4.0 20% solution of calcium patotenata 2.0 to 40% glucose 15 ml solution for each drug and intramuscular 1% solution of riboflavin-mononucleotide 1.0.

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Publication date 27.03.2007gg