On average, 71% of pregnancies end without any problems, perhaps with little help. However, from time to time, it may be necessary to intervene weaving for the safety of the mother and halberd. Artificial pain application is one of these methods. It is used either to initiate dosing or to speed up the process during one of the birth stages. Although it differs from country to country and from clinic to clinic, it is used for initial purposes in 10% of births and in advancing processes in 20-30%.
Why Artificial Pain and How Is It Applied?
The most commonly used drug for artificial pain is the synthetic derivative of the oxytocin hormone produced by the pituitary gland. It is given intravenously, drop by drop in serum. In addition, prastaglandin-impregnated strips and small pills containing this substance are also used for this purpose. Apart from drugs, dilation of the cervix with fingers during manual examination and scraping of the water bladder from the inner surface of the uterus with the fingertip in this session can also initiate pain. do we need to use mini grips in action?
The decision to use artificial pain is an important one. Good judgment should be made, the possibilities of doing and not doing should be discussed with the pregnant woman, and all data should be well documented. Consideration should be given to the appropriate method, appropriate time and appropriate team rule.
In the mild form of preeclampsia, the risk is reduced with high blood pressure, and delivery can be started at 37 weeks. In severe forms, pregnancy is terminated regardless of the gestational week. In order to terminate the pregnancy as soon as possible in severe maternal diseases such as heart, kidney, and lung that do not respond to medical treatments. In the case of an infection called chorioamnionitis, which involves the baby and the uterus.
Growth has stopped in the womb. In cases where the baby may be endangered within a short time, such as disruption of the Doppler test, decreased amniotic fluid. Pregnant women whose water is broken but labor pains do not start within 18-24 hours. In cases where the pregnancy exceeds 41 weeks. In diabetic patients, the expected delivery date despite the possibility of losing the baby internally in the last weeks. 10-15 days before the date. 10-15 days before the expected delivery date in autoimmune immune system and rheumatic diseases, where the probability of baby loss has increased in recent weeks. If the baby is lost in the womb, for delivery as soon as possible. Expecting a big baby that will exceed 4000 grams in a short time, after completing the 38th week without exceeding 4000 grams yet.
In which cases artificial pain should not be applied?
If the baby is too distressed to tolerate the decrease in oxygen between uterine contractions. If the baby's placenta or its vessels are located down, the baby's cord hangs in the vagina. The baby is in the mother's womb, sideways. if it stops. If there is a history of incisions and stitches in the uterus, such as classical cesarean section or myoma surgery. If the mother has active genital herpes at the time of delivery. Such as uterine fibroids, cancer, accidents in the pelvis, post-disease deformations; In situations that will prevent the baby from coming out of the vagina. The cervix usually opens once an hour in first pregnancies, and one cm in half an hour in subsequent pregnancies. If this rate slows down, it is necessary to support uterine contractions. Occasionally, epidural anesthesia can also slow labor. In this case, support with artificial pain may be required.
What to do before artificial pain?
If a significant empty pelvis inconsistency and a large baby with an increased probability of head and shoulder attachment are detected in the vaginal examination, artificial pain is abandoned. The pregnant and their relatives are informed about the method of application, the benefits of the application, and the problems that may be encountered, and approval is obtained. Head level is also important. Bishop score is determined by this examination in which each parameter is evaluated numerically. The higher this value, the more likely the artificial pain will hold. If the cervix is closed, rigid, and turned backward, prostaglandin-impregnated strips are inserted into the vagina 12-24 hours before giving artificial contractions to soften the cervix. After this time spent in the hospital, artificial pain is started.
Routine sweeping or stripping (stripping the water bladder from the inner surface of the uterus with the fingertip) before artificial contractions increases the success. Moment Neither obesity, large baby, advanced maternal age slightly reduce the probability of wasting.
What are the problems that may occur due to the application of artificial pain?
As with any medical practice, this procedure also carries risks. Most of the problems that may arise can be avoided with careful follow-up. Patients undergoing artificial pain are already in the risk group. Therefore, even when artificial labor is not applied, the possibility of cesarean and interventional delivery is high. For this reason, the appropriate method, appropriate time and appropriate team rule are very important. Most troubles don't start suddenly. With good management, dangers can be eliminated.
The most common problem encountered in the application of artificial pain is excessively frequent and hard contraction of the uterus. Contractions that normally come two or three times in ten minutes and last for 30-40 seconds are ideal for labor progress. An increase in the frequency of pain and even the inability of the uterus to relax cause some dangers. Each contraction reduces blood flow to the baby. As the pain becomes more frequent, the baby's oxygen intake begins to be difficult. The baby's heartbeat is disturbed. In order to save the baby, the possibility of using auxiliary methods such as vacuum, emergency cesarean section and the possibility of entering intensive care in the baby increase. In fact, the possibility of rupture of the uterus can be seen very rarely. For this reason, careful monitoring of pain frequency and baby heartbeats prevents this dangerous course. Contrary to this situation, sometimes artificial pain is not effective. Although the cross and meta d are changed, cesarean section can be passed if the application fails.
Artificial pain is more severe than the natural one. Therefore, it increases the possibility of epidural anesthesia. Under normal conditions, epidural anesthesia, which reduces the mother's unbearable labor pains to a bearable level, reduces the possibility of cesarean section due to the fear of pain. However, when the need for epidural anesthesia increases due to artificial pain, it is inevitable that the birth will be prolonged and the possibility of using a vacuum will increase a little. For these reasons, maternal fatigue rarely causes delay in breastfeeding.
Today, the most common reason for the use of artificial labor is the slowdown in the rate of spontaneous labor. When used for this purpose, the probability of cesarean section does not increase, on the contrary, it decreases.
The second most common reason for use is the passing of the day. increases the risk of loss in the womb. After the 42nd game, this probability increases even more. Therefore, if there is no birth until the 41st week, it is necessary to talk to the family about the possibility of waiting with close follow-up or initiating labor with artificial labor. When expected, the loss inside, the risks to be taken due to the growth of the baby and the risks that artificial pain will increase are explained in detail.
41. Weekend examination is very important. If the baby is not large, if the amniotic charge is normal, if there is no deterioration in Doppler tests, if the previously mentioned Bishop score is good, if the NST tests are normal, if there is no decrease in baby movements, once every two or three days, on condition that the water bladder is scraped from the inner surface of the uterus with the fingertip. , wait a few more days; It will carry less risk than artificial pain. In the opposite case, birth is planned. The risks and benefits are explained in detail and acted upon according to the family's decision.
If you have any questions about artificial pain, you can consult the expert team of Grup Florence Nightingale Hospitals. You can reach our expert team by using the contact form or by calling 444 0436.
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