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№4' 2019

OBSTETRICS AND GYNECOLOGY

International Medical Journal, Vol. 25., Iss. 4, 2019, P. 23−30.

DOI (https://doi.org/10.37436/2308-5274-2019-4-6)

STATE OF THE ART OF DISCOORDINATED LABOR PROBLEM

Kharkiv National Medical University, Ukraine

The course and result of childbirth for mother and fetus was evaluated by comparing different ways of correction of discoordinated delivery (clinical protocols, using of epidural anesthesia, combined method with phosphatidylcholine). Among the abnormalities of labors, the frequency of those makes 18−20 %, a discoordination of labor has taken an important place. The discoordination means a disorder in coordinated contractions of different parts of an uterus. It is known that this pathology may result in a high incidence of operative delivery, birth injury, pathological blood losses, postpartum septic complications, maternal and perinatal morbidity. In order to assess the course and outcome of labor for the mother and the fetus, by comparing various methods of correction of discoordinated labor, 120 women in labor were examined, they were divided into clinical groups depending on the correction method described above. We have analyzed the indices of the partograms of women in childbirth, the results of hysterography and cardiotocography, levels of adrenaline, norepinephrine, prostaglandin F2α, endogenous oxytocin in the mother's blood. Hemodynamics in the uterine vessels and the ones of the fetoplacental complex was determined using dopplerometric investiagtions. The condition of the newborns was evaluated. Based on the investigation results of the birth outcome, it has been concluded that the application of phosphatidylcholine in the combined treatment of the discoordinated labor can significantly reduce the frequency of cesarean section surgeries, improve the condition of the fetus and newborn by normalizing the biologically active substances in blood of the mother and fetus, blood flow in the fetoplacental complex, and eliminate the occurrence of abnormal labor.

Key words: labor discoordination, phosphatidylcholine.

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