Miscarriage

So called births that occurred during the gestation of 28 to 38 weeks and ending with the birth of a premature baby .
classificationDepending on the clinical picture of preterm birth can be threatening and start over.
Etiology and PathogenesisPreterm birth can endocrine disorders , infectious diseases , pathology of the endocrine glands, blood incompatibility between mother and fetus , adverse environmental factors .
The clinical pictureIf preterm labor is classified as menacing , the pregnant feels irregular abdominal pain with colicky . At the same time there are nagging back pain , occasionally observed bleeding from the genital tract, but they are either insignificant or not expressed.On examination the uterus is located in an elevated tone. At vaginal examination is often noted that the short cervix , and sometimes may be disclosed by no more than 4 cmWhen do the premature birth , a woman feels the regular contractions . They are similar to normal childbirth, although often rapid that affects the condition of the fetus.
treatmentTo prevent birth injuries and perinatal mortality , it is important to conduct began premature labor : from the doctor must carefully monitor the condition of the cervix , the presenting part of the movement and speed of labor.In the first stage of labor is common to use antispasmodics to avoid rapid or rapid process. If the introduction of muscle relaxants does not have a decisive impact , it is necessary to make incisions on the neck of the uterus, injury to soft birth canal and premature fetus was not excessive .
If there is a weakness in labor , it is accepted to enter various reducing agents, it is very closely monitoring the situation. For example, at this bout time must be short enough and slow . Need while also constantly monitor the heartbeat of the fetus and its condition .
Antispasmodics are as long as the uterus expands to 5-6 cm If the outpouring of the water has already occurred , it is necessary to take preventive measures against fetal hypoxia . To reduce the strong generic activities and to prevent fetal hypoxia , is used in the treatment of superficial ether anesthesia .During the second stage of labor, women also need to be in the lateral position .To the fetus is not injured , many obstetricians practicing pudenalnuyu anesthesia : a fan-shaped area of the perineum is introduced from 64 to 128 IU hyaluronidase with 10 ml of 0.25 % solution of novocaine. It is believed that in this case the fetus is extracted more carefully by caesarean section , however, need to consider that in such circumstances, a crucial role is played by an objective assessment of the viability of the fetus and the likelihood of nursing after his birth.
Typically, preterm labor most affected child's lungs mature enough , so that when the delivery start expectation of not less than 12 hours , it is useful to assign pregnant corticosteroids. During the 12 hours to do two injections of dexamethasone 8 mg intramuscularly.Often in obstetric practice has artificially induce premature labor . These serve as an indication for heavy toxemia of pregnancy , is rapidly developing blood disorders in the activity of the heart , kidneys and liver. Among the indications for Artificial induction of premature birth and fetal deformity are established anomalies of development.
As a labor induction is used intravenous drip of oxytocin in the amount of 5 units , diluted in 500 ml of isotonic sodium chloride solution. You can also combine inject 2.5 units of oxytocin with 2.5 mg of prostaglandin . The introduction rate of the drug is 8-10 to 40 drops per minute. Previously, for 4-6 hours before the procedure, opened membranes.If labor induction is ineffective and the pregnancy is 35 weeks , it is best to cesarean section .
At 36 weeks the fetus continues strong growth ( length up to 48 cm). In the future child begin to function neural cells . By the end of the 36th week of pregnancy the baby is considered premature and possible premature birth .