What is weak labor and how to avoid it? Anomalies of labor activity Why there may be weak labor activity

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What woman doesn’t dream of having a child, much less carrying it and giving birth to it with a favorable outcome?! However, in some cases, pregnancy may proceed in an unplanned form, and various kinds of complications may arise, including insufficient or weak labor activity. In most cases, it can lead to prolonged labor and fetal hypoxia. Currently, there are two forms of complications:

1. primary;
2. secondary.

Most main feature, by which one can judge the presence of weak labor - these are weak and short contractions. The cervix opens slowly or does not happen at all. As a result, the fetus moves very slowly through the birth canal.

Primary form of complication

With primary weakness of labor, one can observe how the opening of the uterine pharynx occurs with a deviation in dynamics. Often the reasons for this phenomenon may be:

• physiological characteristics of the body of each specific pregnant woman;
• low hemoglobin content;
• endocrine and metabolic disorders;
• pathological changes in the uterus;
• too much stretching of the uterus;
• woman’s age (less than 17 years and more than 30 years);
• lack of physical activity;
• menstrual irregularities.

Secondary form of complication

Usually, secondary weakness labor occurs after labor begins and when normal contractions suddenly begin to subside. This type complications develop into in rare cases than the primary form.

By and large, the secondary form can be caused by long and painful contractions, which can be very tiring for any woman. In addition, secondary weakness may result from the irrational use of medications to tone the uterus. In some cases, in order to shorten the labor time, some doctors use special techniques artificially, even in cases where there is no need.

However, the first birth actually takes longer than all subsequent ones. And if there is no threat of hypoxia for the child, then it is not worth inducing labor. In some cases, it is enough for the pregnant woman to calm down a little.

In addition, the reasons for the occurrence of secondary weakness of labor may be the incorrect position of the child, as well as the presence of any inflammatory processes in the pelvic area.

Symptoms

Doctors can identify symptoms of weak labor directly during labor. They can judge this by the nature of the contractions. As a rule, they are short-lived and of low intensity. The intervals between contractions become longer and longer, and their rhythm is disrupted. In addition, signs may be following cases: there is a slow opening of the uterine pharynx, the fetus moves along the birth canal noticeably slower than with normal birth. Labor is slow and can be very tiring for a pregnant woman.

It is worth noting that the primary weakness of labor manifests itself at the very beginning birth process. But secondary weakness of labor most often occurs after labor has already begun, and it began normally.

Stimulation

In some cases, when serious harm can be caused to the child due to protracted labor, they resort to such a forced measure as induction of labor.

Preliminary

It’s good if in any family someone has already had weak labor. Since if you suspect that the birth will be protracted, you can already take care in advance to ensure that it goes easily and quickly. You can start doing preliminary stimulation at 34-36 weeks of pregnancy. Its main principle is to do everything that is usually not recommended when normal course pregnancy: lift weights, you can wash the floor while tilted, and taking a hot bath is also recommended.

Also, a pregnant woman can brew tea from raspberry leaves for herself and drink 2-3 glasses daily. However, even here it is still worth observing some measures and consulting with your doctor.

Non-drug

Stimulation can also be done in maternity hospital, for which a non-drug method can be used. Its essence is to perform an amniotomy - an autopsy amniotic sac. This procedure carried out in cases where the cervix is ​​dilated by 2 or more centimeters. Often, the weakness of labor begins to intensify. Usually in such cases, the pregnant woman is then able to cope with childbirth herself.

Medication

There are cases when amniotomy does not give the necessary results and then they resort to the drug method. There are two types of drug methods for inducing labor:

1. Medication-induced sleep;
2. Stimulation with uterotonics.

With the first method, a pregnant woman can regain her strength within 2 hours while she sleeps. After she wakes up, labor activity in this case also begins to intensify. Sleep occurs after special medical supplies (narcotic analgesics). However, they should be prescribed after consulting with an anesthesiologist and only if no side effects are observed.
The second method is used most often and for its implementation special uterotonics are used, such as oxytocins and prostaglandins. They are introduced into the body of a pregnant woman intravenously or using a dropper. At the same time, the condition of the fetus is monitored using cardiotocography.

If any of the methods does not help, the child is in serious danger, then an emergency caesarean section is performed.

However, in the presence of weak labor, treatment by medicinal method has its contraindications. This is if there is a scar on the uterus due to surgery caesarean section; if nodes are present after uterine fibroids have been removed; if they appear various symptoms which indicate uterine rupture. In some cases, there may be a discrepancy between the size of the child and the pelvic cavity.

Important point: drug treatment clearly requires the use of drugs such as antispasmodics, analgesics, and epidural anesthesia. This is due to the fact that with a sharp increase in labor, a woman may experience strong painful sensations. This suggests that this therapy should be used in special cases.

Preventive actions

In order to prevent primary or secondary weakness of labor, it is necessary to carry out some preventive actions. To do this, it would not hurt for every pregnant woman to attend special courses, during which she can find out what changes occur in her body during pregnancy and how the child himself develops. Besides this she will get everything necessary recommendations regarding what should be done for a successful birth.

The expectant mother must be prepared for the upcoming process of childbirth. She must understand what analgesic and stimulation techniques may benefit her. minimal risk for yourself and your child.
It is worth noting that symptoms of primary weakness of labor appear in 65% of cases when the woman was not prepared for the birth process. The indicators are completely different when a pregnant woman attended, for example, special courses for the purpose of self-development - only 10% of women encountered such a complication.

In order for childbirth to proceed without any complications, you must contact a trusted clinic and trust only qualified specialists. Such a doctor should not prescribe the most extreme measures, like a caesarean section, if there is really no need for it.

It is important that he also takes part while the baby is growing and developing, and approves all the efforts of the mother, which are aimed at ensuring that the birth proceeds naturally. It would be a good idea to work with your doctor to create a birth plan to ensure that future mom does everything right.

If you have had a cesarean section in the past, in which there is a risk of primary weakness of labor, then you should discuss with a specialist all the points regarding practical and psychological preparation for the upcoming birth.

The expectant mother should not forget about herself: she must continue to take care of her health, eat right, and do some permitted physical exercise, avoid bad habits. In this case, the woman will be in the best shape during childbirth.

The doctor's story about how childbirth should proceed

The dilatation was small, but they say this is always the case with first-time mothers. The contractions intensified, and then the pushing came... Before giving birth, I read that they last just nothing, that is, within 2-3 pushings the baby should already be born. But lying in the delivery room, I realized that something was going wrong... and the contractions seemed to have stopped... Then I didn’t know that this was called weak labor, the reasons for which could be very different...

Why are we weak before childbirth?

The doctors began to fuss, brought an IV and began to drip something into me, which caused the contractions to resume. My baby was wrapped in the umbilical cord twice, and the minutes were counting. Thank God, everything worked out, and my son was born healthy, screamed, and I cried with happiness. There were still minor consequences from the fact that the baby was squeezed in the birth canal for a long time... The pediatrician advised us to wear a special cervical collar for a month. So we got by with little loss.

But there are so many cases when all the efforts of the mother and doctors are in vain, and the baby dies before it can be born.

Weakness of labor - serious problem, which occurs in approximately 8% of women in labor and manifests itself in shortening contractions, weakening efforts and the slow passage of the baby through the birth canal.

Because of which modern women, so strong and determined in life, cannot fulfill their main task - to give birth to their baby without complications?
The reasons can be very different, both physiological and psychological. Often the birth process slows down when various diseases genital area ( chronic endometritis, fibroids), with underdevelopment of the uterus (hypoplasia).

Diabetes and obesity can also inhibit labor. If you are having your second birth, and the first one had complications or you had a cesarean section, and besides, the doctor says that the pelvis is anatomically narrow, know that you are also at risk. Often a woman in labor is mentally unprepared for childbirth and has a strong emotional stress slows down labor.
The baby, for its part, can also slow down its own birth. Heavy weight and the circumference of the fetal head will force the mother not only to sweat and try hard, but can also lead to physical exhaustion. It can also be difficult for women in labor with multiple pregnancies.

Weak labor

Labor activity can weaken at any time during the birth process:
Primary weakness of labor. Occurs at the beginning of labor, contractions are very weak, and the dilation of the cervix is ​​slow. Usually, in first-time mothers, dilatation of at least 2-3 cm lasts up to 6 hours, during the second birth - twice as fast. The protracted first stage of labor is very exhausting, the energy and muscles of the uterus weaken, and the baby inside has a hard time. If the doctor does not take action, the child may die.

Secondary weakness of labor. It is discovered at the beginning of the 2nd birth period. The contractions completely subside and the dilatation of the cervix stops. Due to the fact that the baby's head is squeezed by the birth canal, both mother and child suffer. This often leads to the cervix swelling and urinary or rectal problems. vaginal fistulas.

Weakness pushing. Occurs in the final stage of labor. Weak abdominal muscles are to blame, because during pushing the main load falls on them. Typically, these muscles are weakened in women who have had many births and are obese. At the finish line, moral exhaustion reaches its climax. So much effort and no result! But under no circumstances should you give up, the baby is already halfway there, he is also trying and suffering.

Sleep is the best medicine

Modern medicine has a lot effective drugs, due to which it is possible to treat weak labor. Everything is individual.

The doctor decides what exactly can be used based on several factors. The choice of medications is influenced by the phase of labor, the condition of the patient and possible contraindications. For example, if a gynecologist sees that a woman is exhausted already at the beginning of labor, he can inject her with medicinal sleep. It does no harm at all and allows mommy to rest for an hour or two and regain strength before the strongest contractions and attempts.
Doctors often resort to opening the water bladder (amniotomy) if the waters do not break on their own. This usually activates labor. The same is done for polyhydramnios and flat bladder.
In the final stage of labor, if contractions suddenly stop, the woman in labor is given oxytocin or prostaglandins through an IV. They increase uterine contractions. By the way, oxytocin can also be instilled at 41 weeks of pregnancy if the birth does not occur on time.

It happens that all measures do not bring results, and doctors make a drastic decision - to perform a caesarean section on the patient. Sometimes it's the only way out to save the child.

On the prevention of weak labor

How to protect yourself from weak labor? After all, you really want the birth to go well and without force majeure. Many mothers wonder if there is effective prevention in this situation. Drug prevention no and cannot be. Unless, during pregnancy, you need to remember to take vitamins prescribed by the gynecologist and eat them in their “pure” form ( fresh vegetables and fruits).

Don't forget about physical activity. Walking is very useful for strengthening the abdominal muscles. If you are about to give birth for the first time, be sure to attend courses for expectant mothers. This will relieve you of unnecessary anxiety, relieve tension and give you confidence before giving birth. And, of course, do not disturb your sleep and rest patterns. Pregnant women must discipline themselves in this regard.

Late night watching movies and nap will ultimately lead to, and the lack of a normal, full night’s sleep takes a lot of strength and energy. You need to accumulate and preserve all your internal physical and moral resources. They will be very useful to you during childbirth.

Have a good labor, my dears! Well, I’ll go do other activities, household chores. As always, a lot of things have accumulated. I’m not saying goodbye to you, because I’ll be back very soon! I look forward to your comments, stories and reviews.

– contractile activity of the uterus is insufficient in strength, duration and frequency, due to its hypotonic dysfunction. Weakness of labor is manifested by rare, short-lived and ineffective contractions, slower dilation of the cervix and the advancement of the fetus. Pathology is diagnosed through observation, cardiotocography, and vaginal examination. In the treatment of weakness of labor, labor stimulation is used; If indicated, a caesarean section is performed.

General information

Weakness of labor is one of the forms of dysfunction of the contractile function of the uterus, characterized by low myometrial tone, low frequency of contractions, and weak amplitude of contractions. There is a predominance of diastole of contractions (period of relaxation) over systole (period of contraction), which slows down the dilation of the cervix and the advancement of the fetus through the birth canal.

Weakness of labor may be due to the late or young age of the primigravida; gestosis; premature birth or post-term pregnancy; hyperextension of the uterus with multiple pregnancy, large fetus, polyhydramnios; disproportion between the sizes of the fetus and the pelvis of the woman in labor (narrow pelvis); early breaking of water. The development of weakness of labor can be caused by placenta previa, pregnancy occurring in conditions of chronic placental insufficiency, fetal pathology (hypoxia, anencephaly, etc.).

In addition, the weakness of labor can be aggravated by the woman’s asthenia (overwork, excessive mental and physical activity, poor nutrition, insufficient sleep); fear of the mother in labor, an uncomfortable environment, inattentive or rude service. Weakness of labor is often a direct continuation of the pathological preliminary period of labor.

Types of weakness of labor

Based on the time of occurrence, a distinction is made between primary and secondary weakness of labor. Primary weakness is considered to be a situation in which, from the very beginning of labor, insufficiently active (weak in strength, irregular, short-lived) contractions develop. Secondary weakness is spoken of when contractions weaken at the end of the 1st or beginning of the 2nd stage of labor after the initially normal or violent nature of labor.

Types of weakness of labor include segmental and convulsive contractions. Convulsive contractions are characterized by prolonged (more than 2 minutes) contractions of the uterus. During segmental contractions, contraction occurs not of the entire uterus, but of its individual segments. Therefore, despite the continuity of segmental contractions, their effect is extremely small. Definition clinical form weakness of labor allows you to choose differentiated tactics in relation to the treatment of disorders.

Symptoms of weak labor

Clinical manifestations of primary weakness of labor are: decreased excitability and tone of the uterus; frequency of contractions - 1-2 within 10 minutes; the duration of contractions is no more than 15-20 seconds; amplitude (strength) of myometrial contractions - 20-25 mm Hg. Art. The period of uterine contraction is short, the period of relaxation is extended by 1.5-2 times. There is no increase in intensity, amplitude, or frequency of contractions over time.

Contractions with primary weakness of labor can be regular or irregular, painless or slightly painful. Leakage structural changes cervix (shortening, smoothing and opening of the cervical canal and uterine pharynx) is slowed down. Weakness contractile activity the uterus is often accompanied by a period of expulsion, as well as the afterbirth and early postpartum period, which leads to hypotonic bleeding. Primary weakness of labor leads to prolongation of labor, fatigue of the woman in labor, untimely release of amniotic fluid, and prolongation of the anhydrous interval.

In the case of secondary weakness of labor, initially effective contractions weaken, become shorter and less frequent, until they stop completely. This is accompanied by a decrease in the tone and excitability of the uterus. The opening of the uterine pharynx can reach 5-6 cm without further progression; the progress of the fetus through the birth canal stops. The danger of weak labor activity is an increased risk of ascending infection of the uterus, the development of fetal asphyxia or fetal death. When the fetal head remains in the birth canal for a long time, birth injuries to the mother (hematomas, vaginal fistulas) can develop.

Diagnosis of weakness of labor

To determine the nature of labor, they carry out clinical assessment efficiency of contractions, uterine tone, labor dynamics. During childbirth, monitoring of uterine contractions is carried out (tocometry, cardiotocography); The frequency, duration, and strength of contractions are analyzed and compared with the norm. Thus, in the active phase of the 1st period, contractions lasting less than 30 seconds are considered weak. and at intervals of more than 5 minutes; for the 2nd period - shorter than 40 seconds.

When labor is weak, the cervix dilates by less than 1 cm per hour. The degree and speed of dilation are assessed during vaginal examination, and also indirectly - by the height of the contraction ring and the advancement of the head. Weakness of labor is indicated if the first stage of labor lasts for more than 12 hours in primiparous women, and more than 10 hours in multiparous women. Weakness of labor forces should be differentiated from discoordinated labor activity, since their treatment will be different.

Treatment of weakness of labor

The choice of treatment regimen is based on the causes, the degree of weakness of labor, the period of labor, and an assessment of the condition of the fetus and mother. Sometimes, to stimulate the intensity of contractions, it is enough to catheterize the bladder. If the weakness of labor is due to

In the process of pregnancy management, an obstetrician-gynecologist needs to assess risk factors for the development of labor weakness, and if such factors are identified, preventive drug and psychophysical preparation is required. Weakness of labor almost always leads to a deterioration in the condition of the fetus (hypoxia, acidosis, cerebral edema), therefore, simultaneously with labor stimulation, fetal asphyxia is prevented.

In the article we discuss weak labor. We talk about the causes, symptoms and consequences of this condition. You will learn what to do in similar situation and is it possible to intensify contractions?

Weak labor is a condition of the body characterized by insufficient strength of contractile uterine activity, frequency and duration. As a result, contractions are rare and short, and they are ineffective. All this leads to a slow opening of the cervix and the passage of the fetus through the birth canal.

Weak labor can lead to negative consequences

This condition refers to anomalies of generic forces. It is observed in 10% of cases of all unfavorable births. As a rule, pathology is diagnosed during the first birth, less often observed during the second or third.

Classification

Pathology is classified depending on the time of its appearance, and there are two types: primary and secondary. The primary form is characterized by short, ineffective contractions from the beginning of the labor process, while the uterus relaxes for a long time. The secondary form is diagnosed when contractions weaken and shorten after some time of sufficient intensity and duration.

The primary form is more common, its frequency is 8-10 percent. Usually secondary form detected at the end of the period of dilatation or during the expulsion of the fetus, it occurs only in 2.5% of cases of all births.

Experts also note weakness in pushing, observed in multiple births or in obese women with segmental and convulsive contractions. Convulsive uterine contraction is characterized by a prolonged contraction of the uterus (more than 2 minutes), segmental - the uterus does not contract all, but only in separate segments.

Who is at risk

The risk of developing pathology increases in the following cases:

• too young age (under 18 years old) and women in labor over 35 years old;
• a large number of abortions with curettage in history;
• multiple births;
• a large number of births in the anamnesis;
• failure hormonal levels and menstrual dysfunction;
• excess body weight;
• hypertrichosis;
• the presence of uterine hyperextension caused by multiple births, polyhydramnios or a large fetus.

Causes

Why is there weak labor? Here are the main factors causing this condition:

• polyhydramnios;
• large fruit;
• post-term pregnancy;
• overweight;
• hormonal disorders;
• fear of the first birth;
• multiple pregnancy;
• metabolic disease;
• problems with the endocrine system;
• physiological characteristics, for example, narrow pelvis women in labor, flat bladder;
• pathological processes that occur in the uterus;
• overwork;
• lack of sleep.
• any stress experienced.

Many pregnant women wonder if labor is weak during the first birth, then what to expect from the second? No specialist can definitely answer this question, since each new birth may differ from the previous ones. Even if you are giving birth for the fourth or fifth time, the whole process may be different from your previous experience.

Every woman needs the right attitude for childbirth

Symptoms

The clinical picture of weak labor is as follows:

1. Primary weakness - with it, contractions immediately have a short duration and low efficiency, and are practically painless. The periods of relaxation are quite long and almost do not cause the opening of the uterine pharynx. Most often, these signs appear after a pathological preliminary period. Typically, expectant mothers complain of water breaking and weak contractions, which means premature or early rupture of amniotic fluid.
2. Secondary weakness - this symptom is less common, it distinctive feature is a weakening of contractions after a period of effective labor and dilatation of the cervix. Typically occurs at the end active phase when the uterine os opens up to 5-6 cm or during pushing. Initially, contractions are intense and frequent, but gradually lose strength and become shorter, and the movement of the presenting part of the fetus slows down.
3. Weakness of pushing - this condition is usually characteristic of women who have given birth a lot and often, suffer from obesity or divergence of the abdominal muscles. Also, this symptom can be provoked by physical or nervous exhaustion. They manifest themselves as ineffective and weak contractions and attempts, as a result of which it is difficult for the fetus to move along the birth canal, which causes hypoxia.

Diagnostics

To make a diagnosis of “weak labor,” doctors take into account:

• the nature of uterine contractions - their strength, duration of contractions and relaxation time between them;
• as the neck opens, a slowdown in this process is observed;
• advancement of the presenting part - absence of forward movements, the head remains in each plane of the small pelvis for a long time.

An important role in diagnosing weak labor forces is played by maintaining a partogram of labor, thanks to which the process of cervical dilatation and its speed is clearly shown. In first-born women in the latent phase in the 1st period, the uterine os opens approximately by 0.4-0.5 cm per hour, in multiparous women - 0.6-08 cm per hour. As a result, the latent phase in women who are giving birth for the first time lasts approximately 7 hours, in multiparous women - up to 5 hours. Weakness is diagnosed when the delay in cervical dilatation is about 1-1.2 cm per hour.

Contractions are additionally assessed. In the case when in the 1st period their duration is less than half a minute, and the intervals between them exceed 5 minutes, this means primary weakness. Secondary weakness is said to occur when contractions last less than 40 seconds at the end of the first period and during the process of expulsion of the child. It is also important to monitor the condition of the fetus, as protracted labor lead to hypoxia.

What to do

How does labor begin? If the pregnancy is post-term, but the woman’s body is ready for delivery, then the specialist first performs an amniotomy. This procedure is performed only if the cervix is ​​dilated by 2 cm or more.

As a rule, after opening of the amniotic sac, labor increases. After the procedure, the woman in labor is monitored for several hours, after which, if the amniotomy does not produce any results, drug stimulation is used.

The main method of drug stimulation of uterine contractions is the use of uterotonics: oxytocin and prostaglandins, which are administered intravenously. At the same time, the condition of the fetus is monitored using CTG.

In some cases, medicated sleep can be used, which is aimed at restoring the strength of the woman in labor; its duration is approximately 2 hours. It is carried out with the help of analgesics and only after consultation with an anesthesiologist. This technique is used quite rarely and only when the benefit outweighs the possible harm.

If everything Taken measures do not give positive result, an emergency caesarean section is prescribed.

To minimize possible Negative consequences during weak labor, it is important to listen to the doctor’s recommendations and strictly follow them.

How to intensify contractions

Sometimes the following actions will help intensify contractions:

• Calm down, breathe correctly, take certain positions during contractions, and if possible, do self-massage.
• Move as much as possible or jump on an exercise ball.
• If you need to be in horizontal position, then lie on the side where the back of the fetus is located - this will increase the contraction of the uterus.
• Monitor the condition of your bladder and empty it every 2 hours.
• Empty bladder intensifies contractions. If you cannot go to the toilet on your own, use a catheter.

Contraindications

Conservative therapy is prohibited in the following cases:

• the presence of a scar on the uterus, for example, after a caesarean section;
• narrow pelvis of a woman in labor;
• large fruit;
• true post-term pregnancy;
• individual intolerance to uterotonic drugs;
• the child is in a pelvic rather than cephalic presentation;
• intrauterine fetal hypoxia;
• if the woman in labor is over 30 years old and this is her first birth;
• burdened gynecological history;
• burdened obstetric history.

IN similar cases The birth is carried out using an emergency caesarean section.

Cleaning the house in the last weeks of pregnancy will help speed up the onset of labor

Prevention

Is it possible to ensure that childbirth takes place without complications? You cannot directly influence the process of childbirth, but you can prepare for it. For this:

1. WITH last month pregnancy, start taking vitamins B6 and B9 (), as well as vitamin C.
2. Start mentally setting yourself up for a successful outcome of the birth.
3. If possible, attend courses for expectant mothers.
4. Remember, during childbirth, not only you experience difficulties, but also the child.

If anyone among your relatives has experienced prolonged labor, follow these recommendations (but only after your doctor’s permission):

1. From 34-36 weeks of pregnancy, do what was prohibited during pregnancy: actively clean, wash floors at an angle, lift heavy objects, take a hot bath.
2. Drink raspberry leaf tea 2-3 glasses a day.

Consequences

Weakness of generic forces can lead to various unpleasant consequences, including disability in the child, as well as the death of the fetus or mother. But this happens quite rarely; usually a timely caesarean section saves both mother and child.

Remember, the right attitude towards childbirth and following all the recommendations of the obstetrician will allow you to give birth to a healthy and strong baby!

Video: Weak labor

This article will discuss the issue of weakness of labor. We will tell you in detail about the causes, symptoms, consequences and resolution of labor.

For let's denote what it is. Weakness of labor is lack of activity uterus. That is, childbirth is difficult and lengthy, since the uterus contracts poorly, the cervix opens with difficulty and the fetus comes out very slowly and with difficulty. Childbirth does not always go well, as it should, and labor anomalies occur. You will learn about one of them in great detail from this article.

Weakness of labor

As sad as it may sound, labor anomalies are quite common. The reasons for this phenomenon are quite numerous. Now we will talk about the weakness of the birth process.

This is one of possible violations labor activity. With this diagnosis, the contractile function of the uterus, which is necessary for expulsion of the fetus, is weakened. This is due to:

• low ;
• rare contractions;
• weak amplitude of contractions;
• predominance of diastole;
• the period of contractions significantly lags behind the period of relaxation;
• slow dilatation of the cervix;
• slow progress of the fetus.

The symptoms will be presented in more detail in another section. Now let's give some statistics. This diagnosis in obstetrics and gynecology is the most popular, since it is very common complication birth and reason various pathologies both mother and child. Statistics say that more than seven percent of births are complicated precisely by the weakness of labor. And one more fact: this diagnosis They are installed more often in women who are giving birth to their first child. As a rule, subsequent births occur without any difficulties, however, there are cases of diagnosing weakness of labor during subsequent births.

Causes

We explained what weakness of labor is. The reasons may be many factors. We suggest listing them. The reasons for the weakness of labor can be:

• morphological inferiority of the uterus;
• failure hormonal regulation birth process;
• functional inertia of nerve structures;
• extragenital diseases;
• hypoplasia;
• myoma;
• chronic endometritis;
• adenomyosis;
• bicornuate uterus;
• saddle uterus;
• medical abortion;
• scraping;
• conservative myomectomy;
• scars after treatment of cervical erosion (if the woman has not previously given birth).

Some other reasons can be noted. Weakness of labor forces may occur due to an imbalance of factors that influence labor. TO positive factors The following can be included:

• prostaglandins;
• estrogens;
• oxytocin;
• calcium;
• mediators and so on.

Negatively affect:

• progesterone;
• magnesium;
• enzymes that destroy mediators and others.

It is very important to note that women suffering from certain disorders (vegetative-metabolic) often encounter this problem during childbirth. Such violations include:

• obesity;
• hypothyroidism;
• hypofunction of the adrenal cortex;
• hypothalamic syndrome.

The age of the primigravida also has a great influence. If the girl is very young or her age exceeds 35 years, then labor may be difficult. The date at which labor began is also important. Weakness of the uterus can cause post-term pregnancy or premature pregnancy.

If the pregnancy is multiple, it is possible this pathology during childbirth. At multiple pregnancy overstretching of the uterus occurs. Overdistension can also occur with a large fetus or polyhydramnios.

Miniature girls often face difficulties in labor, since a narrow pelvis is also the cause of weak functioning of the uterus. The reason is the disproportion between the size of the child and the woman’s pelvis.

The reasons are still very numerous; unfortunately, it will not be possible to list them all. Now let's highlight some of the most popular ones:

• overwork;
• mental stress;
• physical exercise;
• poor nutrition;
• lack of sleep;
• fear of childbirth;
• discomfort;
• poor care for the mother in labor and so on.

Thus, all reasons can be classified as follows:

• on the mother's side;
• pregnancy complications;
• from the child's side.

Kinds

Weakness of labor can occur at absolutely any stage of labor. In this regard, it is customary to distinguish some types of weakness:

• primary;
• secondary;
• weak attempts.

We propose to consider each type separately in a little detail.

Primary weakness of labor is characterized by inactive contractions in the first stage of labor. They are very weak, short and not rhythmic at all. It is important to note that with primary weakness, decreased uterine tone is noticed (less than 100 mm Hg). At this stage, the woman is able to diagnose the problem herself. How to do this? Time ten minutes and count the number of contractions during this period. If the number does not exceed two and you practically do not feel them, then the diagnosis has been confirmed. You can also measure the time of one contraction; it should be more than 20 seconds in the absence of weakness of labor. Diastole, or the rest period, is almost doubled. How can the sensation of contractions indicate a problem? It's simple, if they are painless or slightly painful, then the pressure from the uterus is not enough to open the cervix.

Secondary weakness of labor is characterized by a weakening of the intensity of the uterus. Before this, contractions could have been normal. The reasons for the development are the same as for the primary weakness of the generic forces. Another indicator is the progression of the opening of the uterine pharynx. If progress is not visible after five to six centimeters of dilation, then we can confidently speak of secondary hypotonic dysfunction of the uterus.

If primary and secondary weakness is observed in ten percent of cases of unfavorable labor and is characteristic of primiparous women, then weakness of the pushing period is extremely rare (two percent of all cases of difficult labor), and it is characteristic of multiparous women or obesity.

Symptoms

Symptoms of primary weakness of labor include:

• decreased excitability of the uterus;
• decreased uterine tone;
• reduced frequency of contractions (up to two in ten minutes);
• short duration of contractions (up to twenty seconds);
• the contraction force does not exceed 25 mm Hg. Art.;
• short period reductions;
• extended rest period;
• there is no increase in intensity and frequency;
• painlessness or low pain of contractions;
• slow changes in the structure of the cervix (this includes shortening, smoothing and dilation).

All this can significantly increase total time childbirth This, in turn, has a bad effect on the mother and the child. The woman in labor becomes very tired, early expulsion of water is possible.

Symptoms of secondary weakness:

• weakening of the intensity of contractions (possibly even their complete cessation);
• weakening of tone;
• decreased excitability;
• there is no progression of opening of the uterine pharynx;
• stopping the advancement of the fetus through the birth canal.

This is no less dangerous than primary weakness. The baby may develop asphyxia or die. For the mother, this is dangerous due to the possibility of infection of the uterus and birth injuries. Prolonged standing of the baby's head in the birth canal can lead to the formation of hematomas or fistulas.

Diagnostics

In this section we will talk about diagnosing the problem of weakness (primary and secondary) of labor. The diagnosis of primary weakness is made on the following basis:

• decreased uterine activity;
• reduced rate of cervical effacement;
• delayed opening of the uterine pharynx;
• long standing of the fetus;
• increased labor time.

It's important to note that big influence The partogram (or graphic description of childbirth) influences the diagnosis. This diagram shows everything:

• cervical dilatation;
• fetal advancement;
• pulse;
• pressure;
• baby's heartbeat;
• contractions and so on.

If there is no progress in dilation of the cervix within two hours, which is clearly presented in the partogram, then this diagnosis is made.

Diagnosis of secondary weakness is based on these indicators:

• partograph;
• listening to the heartbeat.

This is necessary to prevent the fetus from developing hypoxia. There are some difficulties in the labor process that are symptomatically similar to weakened labor. These include:

• pathology;
• discoordination of labor;
• clinically narrow pelvis.

Treatment

It is important to note that treatment is selected individually for each woman in labor. When treating, the doctor must take into account all the data he has (the condition of the woman and baby).

A good remedy for weak labor - a technique for this is introduced special drugs so that the woman can rest, then labor may intensify.

If this does not help, then they resort to puncturing the amniotic sac. After this procedure, labor becomes much more intense. It is worth noting that the puncture is carried out only if the cervix is ​​ready.

Sometimes doctors resort to drug stimulation. Now we will briefly look at the drug “Miropriston” for inducing labor. This drug should be taken strictly under the supervision of doctors. It suppresses progesterone, which has beneficial influence on contractile activity of the uterus.

Delivery

If no methods help, including “Miropriston” to induce labor, then the doctor can carry out emergency surgery caesarean section. What techniques are performed before surgery:

• medicated sleep;
• amniotomy;
• drug stimulation.

Among other things, there may be additional indications for surgery. There is a certain list of contraindications to stimulation of labor (narrow pelvis, threat to life, and so on).

Prevention

We examined in detail the issue of weakness of labor. The obstetrician-gynecologist who is caring for your pregnancy can give advice on prevention. He should talk about possible complications during childbirth and carry out physical and psychological preparation women in labor. In addition to labor stimulation, prophylaxis is mandatory possible complications in the fetus.

Consequences

What are the complications of weak labor? For mom this could be:

• formation of hematomas;
• fistula formation;
• possible infection.

The following complications are possible for the child:

• hypoxia;
• acidosis;
• cerebral edema;
• death.

It all depends on the professionalism of the doctor. With proper stimulation and strict monitoring of the condition of the child and mother, there should be no consequences.

Forecast

Now briefly about predicting the weakness of labor. As mentioned earlier, everything depends on the professionalism of the doctor and psychological state women. Don't panic, but listen to the recommendations of a specialist. Complications after obstructed labor are quite rare.

The course of subsequent births

The weakness of labor during the first birth does not mean that all subsequent ones will proceed similarly. Primary and secondary weakness often occurs in women who give birth to their first child. A small percentage of multiparous women may experience weakness during the pushing period.