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What is weak labor? Voronezh. Weak labor: what to do if contractions are weak What does weak labor mean?

Update: October 2018

Not all births proceed “as expected” and without complications. One of these problems during childbirth is the formation of weakness labor activity, which can occur in both primiparous and multiparous women. Weak contractions during childbirth are anomalies of labor forces and are observed in 10% of cases of all unfavorable births, and in the first birth they are diagnosed more often than in repeated ones.

Weakness of generic forces: what is the essence

We speak about the weakness of labor forces when the contractile activity of the uterus is of insufficient strength, duration and frequency. As a result, contractions become rare, short and ineffective, which leads to a slowdown in the opening of the cervix and the advancement of the fetus. birth canal.

Classification of weak labor

Depending on the time of occurrence, weak labor can be primary or secondary. If the contractions are from the very beginning birth process ineffective, short, and the period of uterine relaxation is long, then they speak of primary weakness. In the case of weakening and shortening of contractions after a certain period of time of sufficient intensity and duration, a diagnosis of secondary weakness is made.

Secondary weakness, as a rule, is noted at the end of the period of dilatation or during the process of expulsion of the fetus. Primary weakness is more common and its incidence is 8 – 10%. Secondary weakness is observed in only 2.5% of cases of all births.

Also identified are weakness of pushing, which develops in multiparous women or in obese women in labor, and convulsive and segmental contractions. Convulsive contractions are indicated by prolonged contractions of the uterus (more than 2 minutes), and with segmental contractions, the uterus does not contract entirely, but only in separate segments.

Causes of weak contractions

Certain reasons are necessary for the formation of weakness of labor. Factors that contribute to this pathology are divided into a number of groups:

Obstetric complications

IN this group includes:

  • prenatal rupture of water;
  • disproportion between the sizes of the fetal head (large) and the mother’s pelvis (narrow);
  • changes in the walls of the uterus caused by dystrophic and structural processes (multiple abortions and uterine curettage, fibroids and uterine surgeries);
  • rigidity (inextensibility) of the cervix that occurs after surgical treatment diseases of the cervix or damage to the cervix during childbirth or abortion;
  • and multiple births;
  • large size of the fetus, which overstretches the uterus;
  • incorrect location of the placenta (previa);
  • presentation of the fetus with the pelvic end;

Besides, great value functionality plays a role in the occurrence of weakness amniotic sac(with a flat membrane, for example, with, it does not act as a hydraulic wedge, which inhibits cervical dilatation). We should not forget about the woman’s fatigue, asthenic body type, fear of childbirth and mental and physical stress during gestation.

Pathology of the reproductive system

Sexual infantilism and congenital anomalies development of the uterus (for example, saddle or bicornuate), chronic inflammation the uterus contributes to the development of pathology. In addition, a woman’s age (over 30 and under 18) affects the production of hormones that stimulate uterine contractions.

This group also includes violations menstrual cycle And endocrine diseases (hormonal imbalance), recurrent miscarriage and disturbances in the formation of the menstrual cycle (early and late menarche).

Extragenital diseases of the mother

This group includes various chronic diseases women (pathology of the liver, kidneys, heart), endocrine disorders(obesity, ), numerous infections and intoxications, including bad habits and industrial hazards.

Factors due to the fetus

Intrauterine infection of the fetus and developmental delay, fetal malformations (anencephaly and others), post-term pregnancy (overripe fetus), as well as premature birth may contribute to weakness. In addition, Rh conflict during pregnancy, fetoplacental insufficiency, etc. are important.

Iatrogenic causes

This group includes “hobby” with birth-stimulating drugs that tire a woman and disrupt uterine contractile function, neglect of labor pain relief, unjustified amniotomy, as well as rough vaginal examinations.

As a rule, not one factor, but a combination of them, plays a role in the development of weakness of contractions.

How does pathology manifest itself?

Depending on the type of weakness of the generic forces, the clinical manifestations differ somewhat:

Primary weakness

Contractions in the case of primary weakness are initially characterized by a short duration and poor efficiency, little or no pain, periods of diastole (relaxation are quite long) and practically do not lead to the opening of the uterine pharynx.

As a rule, primary weakness develops after pathological preliminary period. Often, women in labor complain that their waters have broken and the contractions are weak, which indicates either premature or early rupture of water.

As you know, the role of the amniotic sac in childbirth is enormous; it is the one that puts pressure on the cervix, causing it to stretch and shorten; untimely release of water disrupts this process, and uterine contractions become insignificant and short-lived. The frequency of contractions does not exceed one or two during a 10-minute period (and normally should be at least 3), and the duration uterine contractions reaches 15 – 20 seconds. If the amniotic sac has retained its integrity, then it is diagnosed as non-functional, it is sluggish and does not flow well into contractions. There is also a slowdown in the advancement of the fetal head; it remains in the same plane for up to 8–12 hours, which not only causes swelling of the cervix, vagina and perineum, but also contributes to the formation of a “birth tumor” of the fetus. The long course of labor exhausts the woman in labor, she gets tired, which only worsens the birth process.

Secondary weakness

Secondary weakness is less common and is characterized by a weakening of contractions after a period of effective labor and dilatation of the cervix. It is observed more often at the end of the active phase, when the uterine pharynx has already reached an opening of 5–6 cm or during the period of pushing. Contractions are initially intense and frequent, but gradually lose strength and become shorter, and the movement of the presenting part of the fetus slows down.

Weakness of pushing

This pathology (pushing is a controlled contraction of the abdominal muscles) is more often diagnosed in frequent and multiparous women who have overweight or separation of abdominal muscles. Also, weak pushing may be a natural consequence of weak contractions due to physical and nervous exhaustion and fatigue of the woman in labor. It manifests itself as ineffective and weak contractions and attempts, which slows down the progress of the fetus and leads to its hypoxia.

Diagnostics

To make a diagnosis of weak contractions, consider:

  • the nature of uterine contractions (strength, duration of contractions and relaxation time between them);
  • the process of opening the cervix (slowing down);
  • advancement of the presenting part (no forward movements, the head stands for a long time in each plane of the small pelvis).

An important role in diagnosing pathology is played by maintaining a partogram of labor, which clearly shows the process and its speed. During the latent phase in primiparous women in the first period, the uterine os opens by approximately 0.4 - 0.5 cm/h (in multiparous women it is 0.6 - 0.8 cm/h). Thus, the latent phase normally lasts about 7 hours in primiparous women, and up to 5 hours in multiparous women. Weakness is indicated by a delay in the opening of the cervix (about 1 - 1.2 cm per hour).

Contractions are also assessed. If in the first period their duration is less than 30 seconds, and the intervals between them are 5 or more minutes, they speak of primary weakness. Secondary weakness is indicated by a shortening of contractions of less than 40 seconds at the end of the first period and during the period of fetal expulsion.

It is equally important to assess the condition of the fetus (listening to the heartbeat, performing CTG), since with weakness, labor becomes protracted, which leads to the development of hypoxia of the child.

Management of childbirth: tactics

What to do if labor is weak. First of all, the doctor should determine the contraindications for conservative treatment pathologies:

  • there is a scar on the uterus (after myomectomy, suturing of the perforation hole and other operations);
  • narrow pelvis(anatomically narrowed and clinically);
  • large fruit;
  • true post-term pregnancy;
  • intrauterine fetal hypoxia;
  • allergy to uterotonic drugs;
  • breech presentation;
  • burdened obstetric and gynecological history (placenta previa and abruption, scars on the cervix and vagina, their stenosis and other indications);
  • first birth in women over 30.

IN similar situations the birth ends with an emergency caesarean section.

What should a woman in labor do if contractions are weak?

Undoubtedly, a lot depends on the woman when contractions are weak. First of all, it all depends on her mood successful outcome childbirth Fears, fatigue and pain negatively affect the birth process, and, of course, the child.

  • The woman should calm down and use non-drug methods of labor pain relief (massage, correct breathing, special positions during contractions).
  • In addition, it provides positive influence During childbirth, the woman’s active behavior is walking, jumping on a special ball.
  • If she is forced to be in a horizontal position (“there is an IV”), then she should lie on the side where the fetal back is located (the doctor will tell you). The baby's back puts pressure on the uterus, which increases its contractions.
  • In addition, it is necessary to monitor the condition of the bladder (empty approximately every 2 hours, even if there is no desire).
  • Emptied bladder Helps strengthen contractions. If you cannot urinate on your own, the urine is removed with a catheter.

What can doctors do?

Medical tactics for managing labor with this pathology depend on the cause, period of labor, type of weakness of contractions, and the condition of the mother and fetus. In the latent phase, when the opening of the cervix has not yet reached 3–4 cm, and the woman experiences significant fatigue, it is prescribed medicated sleep-rest.

  • Medication-induced sleep is carried out by an anesthesiologist by administering sodium hydroxybutyrate diluted with 40% glucose.
  • In the absence of an anesthesiologist, the obstetrician prescribes a complex the following drugs: promedol (narcotic analgesic), relanium (sedative), atropine (increases the effect of the drug) and diphenhydramine (sleeping pill). Such a dream allows a woman to rest for 2-3 hours, restore strength and helps intensify contractions.
  • But medicinal rest is not prescribed if there are indications for an emergency cesarean section (fetal hypoxia, abnormal position, etc.).

After the woman in labor rests, the condition of the fetus, the degree of cervical dilatation, and the functionality of the amniotic sac are assessed. A hormonal-energy background is created using the following drugs:

  • ATP, cocarboxylase, riboxin (energy support for the woman in labor);
  • glucose 40% - solution;
  • intravenous calcium preparations (chloride or gluconate) – increase uterine contractions;
  • vitamins B1, E, B6, ascorbic acid;
  • piracetam (improves uterine circulation);
  • estrogens on ether intrauterinely (into the myometrium).

If there is a flat amniotic sac or polyhydramnios, early amniotomy is indicated, which is performed when the cervix is ​​dilated by 3–4 cm, which serves prerequisite. Opening the amniotic sac is an absolutely painless procedure, but it promotes the release of prostaglandins (intensifies contractions) and intensifies labor. 2 - 3 hours after the amniotomy is performed again vaginal examination in order to determine the degree of cervical dilatation and resolve the issue of labor stimulation with contractile drugs (uterotonics).

Drug labor stimulation

To intensify contractions, the following methods of drug labor stimulation are used:

Oxytocin

Oxytocin is administered intravenously. It enhances myometrial contraction and promotes the production of prostaglandins (which not only intensify contractions, but also affect structural changes in the cervix). But it should be remembered that exogenously administered (foreign) oxytocin suppresses the synthesis of one’s own oxytocin, and when the drug infusion is discontinued, secondary weakness develops. But it is also not advisable to administer oxytocin for a long time, over several hours, since this delays urination. The drug begins to be administered when the cervical opening is greater than 5 cm and only after the water has broken or an amniotomy has been performed. Oxytocin in an amount of 5 units is diluted in 500 ml of saline and dripped, starting at a speed of 6 - 8 drops per minute. You can add 5 drops every 10 minutes, but exceeding 40 drops per minute. Among the disadvantages of oxytocin, it can be noted that it inhibits the production of surfactant in the lungs of the fetus, which, if it has chronic hypoxia may cause intrauterine aspiration of water, poor circulation in the baby, and death during childbirth. Oxytocin infusion is carried out with the mandatory (every 3 hours) administration of antispasmodics or with EDA.

Prostaglandin E2 (prostenon)

Prostenon is used in the latent phase, before the cervix opens by 2 fingers, when primary weakness is diagnosed against the background of an “insufficiently mature” cervix. The drug causes coordinated contractions with good relaxation of the uterus, which does not interfere with blood circulation in the fetus-placenta-mother system. In addition, prostenon promotes the production of oxytocin and prostaglandin F2a, and also accelerates the maturation of the cervix and its opening. Unlike oxytocin, prostenon does not cause an increase in blood pressure and does not have an antidiuretic effect, which makes it possible to use it in women with preeclampsia, kidney pathology and hypertension. Contraindications include: bronchial asthma, and intolerance to the drug. Prostenon is diluted and dripped in the same dosage (1 ml of 0.1% drug) as oxytocin.

Prostaglandin F2a

Prostaglandins of this group (enzaprost or dinoprost) are effectively used in the active phase of cervical dilatation, that is, when the pharynx is opened by 5 cm or more. These drugs are strong stimulators of uterine contractions, narrowing blood vessels, which leads to increased pressure, and also thickens the blood and enhances its coagulability. Therefore, they are not recommended for use in cases of gestosis and blood pathology. Side effects (in case of overdose) include nausea and vomiting, hypertonicity of the lower uterine segment. Administration regimen: 5 mg of enzaprost or dinoprost (1 ml) is diluted in 0.5 liters of physiological solution. The drug is started to be administered intravenously with 10 drops per minute. You can increase the number of drops every 15 minutes, adding 8 drops. Maximum speed– 40 drops per minute.

The combined administration of oxytocin and enzaprost is possible, but the dosage of both drugs is halved.

Simultaneously with drug labor stimulation, fetal hypoxia is prevented. To do this, use the triad according to Nikolaev: 40% glucose with ascorbic acid, aminophylline, sigetin or cocarboxylase intravenously, inhalation of humidified oxygen. Prophylaxis is prescribed every 3 hours.

Surgical treatment

If there is no effect from drug stimulation of labor, as well as in the case of deterioration of the fetus’s condition in the first stage, the birth is completed surgically - by caesarean section.

If efforts and contractions are weak during the expulsion period, either obstetric forceps are applied (with obligatory bilateral episiotomy) or a Werbow bandage (a sheet thrown over the mother's stomach, the ends of which are pulled down on both sides by assistants, squeezing out the fetus).

Question and answer

  • I had weak labor during my first birth. Is it necessary for this pathology to develop during the second birth?

No, not at all necessary. Moreover, if the reason that led to the emergence this complication in the first birth, will be absent. For example, if there was a multiple pregnancy or a large fetus, which caused overstretching of the uterus and the development of weakness, then most likely similar reason will not happen again in the next pregnancy.

  • What threatens the weakness of the generic forces?

This complication contributes to the development of fetal hypoxia, infection (with a long anhydrous interval), swelling and necrosis of the soft tissues of the birth canal with subsequent formation of fistulas, postpartum hemorrhage, uterine subinvolution, and even fetal death.

  • How to prevent the occurrence of labor weakness?

To prevent this complication, a pregnant woman should attend special courses that teach about methods of independent pain relief during childbirth, the birth process itself, and set the woman up for a favorable outcome of childbirth. She also needs to adhere to the correct and rational nutrition, monitor your weight and perform special physical exercise, which not only prevents the formation of a large fetus and development, but also maintains the tone of the uterus.

  • During my first birth they gave me C-section Regarding the weakness of contractions, can I give birth on my own during the second birth?

Yes, such a possibility cannot be excluded, but subject to the absence of those indications that led to the operation for the first time (breech presentation, narrow pelvis, etc.) and the consistency of the scar. In this case, the birth will be planned in a special maternity hospital or perinatal center, where there is the necessary equipment and doctors with experience in managing births with a uterine scar.

Every woman dreams of safely bearing a child for the required nine months and easily giving birth to it by the appointed time. But sometimes complications occur during childbirth and things don't go as you planned.

One of the most common causes of complicated labor is weak or insufficient labor, which leads to a delay in the labor process and, as a consequence, to fetal hypoxia.

Weakness of labor is manifested in weak, short contractions, which slow down not only the smoothing and opening of the cervix, but also the advancement of the fetus along the mother’s birth canal. Weakness of labor forces is more common in primiparous women.

Weak labor may be primary and secondary.

Primary weakness of labor

lies in the absence of normal dynamics of opening of the uterine os, despite the fact that contractions are already underway.

The primary reason for the lack of labor dynamics may be:

Stress is one of the the most important reasons weak labor activity. An unprepared woman develops fear of the upcoming birth; fear disrupts hormonal balance. The disorder occurs because hormones that stop labor are produced by the body in more than hormones that speed up labor. Sometimes one careless or harsh word maternity hospital staff.

Physiological features: flat bladder, which prevents the child from descending; narrow pelvis in a woman in labor.

Low hemoglobin.

Endocrine and metabolic disorders.

Pathological changes in the uterus (inflammation, degenerative disorders, uterine scar, uterine malformations, uterine fibroids).

Overdistension of the uterus (polyhydramnios, multiple births, large fetus).

Age under 17 years and over 30 years.

Weak physical activity during pregnancy.

Secondary weakness of labor

develops after the onset of labor, when contractions that begin normally “fade” at some point.

Secondary weakness of labor develops less frequently than primary weakness, and, as a rule:

It is a consequence of long and painful contractions that lead to fatigue of the woman in labor;

Irrational use of drugs that affect uterine tone. Unfortunately, in order to make labor go faster, doctors quite often speed it up artificially even when it is not necessary.

In addition, labor, especially the first one, can actually take a long time, and if there is no threat of hypoxia for the fetus, there is no need to induce labor. Sometimes, to restore labor, it is enough for a woman in labor to calm down and rest a little.

Induction of labor is a non-drug method.

The actions of the obstetrician depend, first of all, on the cause of the weakness of labor.

However, if prolonged labor really becomes dangerous for the child and mother, then if labor is weak, it is customary to induce labor.

The main non-drug method, allowing to enhance labor activity, is amniotomy(opening of the amniotic sac), which is performed when the cervix is ​​dilated by 2 cm or more. As a result of amniotomy, labor often increases, and the woman in labor copes on her own, without the administration of medications.

Induction of labor is a medicinal method.

If amniotomy does not have the desired effect, then medications are used in maternity hospitals:

1. Medication-induced sleep, during which the woman in labor restores the strength and energy resources of the uterus. After waking up, on average 2 hours later, labor intensifies in some women in labor. Medication-induced sleep occurs after administration of drugs from the group narcotic analgesics, which should be done only after consulting an anesthesiologist and only in cases where side effects on the part of the fetus are less significant than the danger of prolongation of labor for the child.

2. Stimulation with uterotonics. The most common uterotonics are oxytocin and prostaglandins. The drugs are administered intravenously through a dropper, with careful dosage. The condition of the fetus must be monitored using a heart monitor.

Disadvantages of stimulant drugs

As a rule, their use clearly requires the use of antispasmodics, analgesics, or epidural anesthesia. This is due to the fact that a sharp increase in labor activity often increases painful sensations in a woman in labor. Therefore, it is clear that labor-stimulating therapy should be used only when medical indications, when the harm from its use is lower than the harm from prolonged labor.

C-section

If the use of drugs that speed up labor and enhance labor activity does not have any effect, and the fetus suffers from hypoxia, the choice may be made in favor of an emergency cesarean section.

Prevention of weak labor.

TO preventive measures to prevent weakness of labor activity includes, first of all:

1. A woman’s visit to special preparatory courses, in which the woman in labor finds out what is happening to her and the baby, and what she needs to do in order for the birth to be successful. The expectant mother must be ready to actively participate in the birth process, must have a say in decision-making and the use of non-pharmacological methods of pain relief and stimulation of the birth process. It is known that among unprepared women in labor, weakness in labor occurs in 65%, and women in labor who attended childbirth preparation courses or expectant parent schools during pregnancy encounter this complication only in 10% of cases, and they are usually caused by truly objective factors. reasons.

2. Find a hospital and doctor you trust and who is not prone to unnecessarily performing a C-section. It is important that he approves of your efforts to prepare for a vaginal birth. Prepare a birth plan with your doctor to ensure you have the same priorities. If you have had a caesarean section in the past, discuss mental and practical preparation for childbirth.

3. Consider the participation of another assistant (besides your partner) - an experienced person who shares your aspirations.

4. Take care of your health (eat well, exercise, manage stress, avoid alcohol and tobacco) and you'll be in the best possible shape for labor and delivery.

5. As a preventive measure against labor weakness, from 36 weeks of pregnancy, pregnant women are recommended to take vitamins that increase the energy potential of the uterus (vitamin B6, folic acid, ascorbic acid).

Have an easy birth!

Editorial office of the Voronezh Family Portal

Along with the exacerbation of maternal instinct, towards the end of pregnancy, many women experience anxiety about the upcoming birth. This is understandable, since the birth of a beloved and long-awaited baby is a fairly important and responsible event in a woman’s life. If the pregnancy proceeded without complications, all the mother needs to do for a successful birth is to trust nature. Yes, yes, it is nature, and not the obstetrician-gynecologist, whose powers include monitoring the normal course of childbirth and providing medical care only if something doesn't go according to plan. Female body initially programmed to bear offspring, therefore, everything that happens to the expectant mother during childbirth is quite natural.

Sometimes it happens that labor, for one reason or another, does not begin in due date. Well, the expectant mother can’t go around forever pregnant, so they come to the rescue various methods stimulation of labor.

Stimulation of labor. Salvation or harm?

Undoubtedly, pregnant women do not like interference in the mysterious and amazing process of childbirth. Most women want their baby to be born without any medications or medical manipulations, but in some cases this cannot be avoided.

In the absence special indications, labor stimulation is carried out when:

  • pregnancy period is more than 40 weeks;
  • pregnancy period is more than 38 weeks (with multiple pregnancies);
  • there are no signs of the onset of labor.

A pregnancy is considered full-term if it reaches a full 38 weeks. After 40 weeks of pregnancy, in the absence of spontaneous labor, stimulation of labor is indicated. Starting from the 41st week of gestation, the function of the placenta decreases, which means that the child does not receive enough nutrients and oxygen supplied through the bloodstream. Some doctors follow expectant management for 10 days, while others give the woman 2 weeks to give birth on her own. In any case, than longer baby is in the womb after 40 weeks of pregnancy, the more difficult it will be for him during childbirth.

As for multiple pregnancy, upon reaching the full 38 weeks, it is advisable to stimulate labor, which is carried out in order to prevent complicated and pathological childbirth.

IMPORTANT! After 40 weeks bone tissue The fetus begins to actively store calcium. This causes the bones of the baby's skull to become harder, which prevents the head from forming normally as it passes through the birth canal.

Stimulation of labor. In what cases is this really necessary?

Post-term pregnancy - more than 41 weeks.

Ultrasound shows signs of disruption of the utero-fetal-placental blood flow; ossification points are visualized in the fetus.

Premature effusion amniotic fluid.

The lack of stimulation of labor one day after the rupture of amniotic fluid increases the risk of infection of the fetus, as well as the development of septic complications in the mother.

Overstretched uterus.

During multiple pregnancy and polyhydramnios, the walls of the uterus become thinner, resulting in a significant reduction in its contractility.

Diabetes mellitus. Stimulation of labor in in this case carried out after 38 weeks of pregnancy, due to the active weight gain of the fetus in the last two weeks of pregnancy.

Both pregnant women and doctors want all births to take place without complications. But, despite this, complications still occur, and one of them is weakness of labor. It is characterized by weakening and shortening of contractions, slowing down the opening of the cervix and the movement of the fetal head along the birth canal. In primiparous women, labor weakness is twice as common as in multiparous women.

Classification of weakness of labor

Weakness of labor can occur both in the first and second stages of labor, and in connection with this they distinguish:

  • primary weakness of labor;
  • secondary weakness of labor;
  • weakness pushing.

Causes of weakness of labor

The causes of weak labor can be divided into three groups: maternal, fetal and pregnancy complications.

From the mother's side:

  • diseases of the uterus (uterine fibroids, endometriosis, chronic endometritis);
  • extragenital diseases ( diabetes mellitus, hypothyroidism, obesity);
  • infantilism of the genital organs (hypoplasia of the uterus);
  • anatomically narrow pelvis;
  • nervous overstrain of a woman, lack of psychoprophylactic preparation for childbirth;
  • surgeries on the uterus (caesarean section, myomectomy);
  • age of the woman in labor (over 30 years and under 18);
  • rigidity (reduced elasticity) of the genital tract.

From the fetus:

  • large size of the fruit;
  • multiple births;
  • incorrect presentation or insertion of the fetal head;
  • discrepancy between the sizes of the fetal head and pelvis.

Complications of pregnancy:

  • polyhydramnios (overstretching of the uterus and decreased contractility);
  • oligohydramnios and flaccid amniotic sac (flat); gestosis, anemia of the pregnant woman.

Primary weakness of the generic forces

Primary weakness of labor occurs with the onset of labor and is characterized by weak, painless contractions, their frequency is no more than 1-2 per 10 minutes, and their duration is no more than 15-20 seconds. The opening of the uterine pharynx is very slow or does not occur at all. In primiparous women, the opening of the cervix to 2-3 cm from the beginning of contractions takes more than 6 hours, and in multiparous women it takes more than 3 hours.

Such ineffective labor activity leads to fatigue of the woman in labor, depletion of the energy reserves of the uterus and intrauterine hypoxia of the fetus. The fetal head does not advance, the amniotic sac does not function, it is weak. Childbirth threatens to become protracted and lead to the death of the child.

Secondary weakness of the generic forces

Secondary weakness of labor usually occurs at the end of the first or at the beginning of the second stage of labor and is characterized by a weakening of labor after a fairly intense onset and course. Contractions slow down and may stop altogether. The opening of the cervix and the advancement of the fetal head are suspended, signs of intrauterine suffering of the child appear, prolonged standing of the fetal head in one plane of the small pelvis can lead to swelling of the cervix and the occurrence of urinary or rectovaginal fistulas.

Weakness of pushing

Weakness of pushing usually occurs in multiparous women (weakening of the abdominal muscles), in women in labor with separation of the anterior muscles abdominal wall(hernia of the white line of the abdomen), in obese women. Characterized by weakness of pushing, ineffective and short-lived pushing (pushing is carried out using the abdominal muscles), physical and nervous exhaustion mothers, the appearance of signs of fetal hypoxia and stopping its movement along the birth canal.

Treatment of weakness of labor

Treatment of weakness of labor forces should be carried out individually in each case, taking into account the history of the woman in labor and clinical picture. Medicinal sleep-rest helps a lot, especially when the mother is very tired.

For this purpose, antispasmodics, painkillers and sleeping pills. Sleep on average lasts no more than 2 hours, after which labor usually resumes and becomes intense.

In case of flat membranes, polyhydramnios or long term During childbirth, the amniotic sac is opened (amniotomy). Also, the woman in labor is advised to lie on the side where the back of the fetus lies (additional stimulation of the uterus).

Weak labor activity – quite serious pathology, which occurs in approximately every 15th woman. First of all, it can be very dangerous for an unborn baby, since it quite often provokes oxygen starvation brain structures. In addition, this disorder significantly delays the birth process and is very draining. physical strength women in labor.

In most cases similar pathology observed during second births, however, it is not at all excluded in first-time women.

In this article we will tell you what reasons can cause weak labor, what symptoms and signs characterize it, and also how to act in this situation medical workers and what should the pregnant woman do?

What reasons cause weakness of labor?

There may be several reasons for weak labor various factors, in particular:

  • multiple pregnancy or large fetus, as well as other reasons that lead to
    hyperextension of the uterus;
  • various somatic, cardiological and neuroendocrine diseases of a pregnant woman;
  • some pathologies of the myometrium;
  • fetal malformations – adrenal aplasia, various disorders nervous system and so on;
  • placenta previa, as well as its delayed or accelerated maturation;
  • mechanical obstacles, such as various malignant and benign neoplasms, too narrow pelvis, incorrect position of the baby in the uterus, inelasticity of the cervix and others;
  • the age of the woman giving birth is less than 17 and over 35 years;
  • insufficient motor activity the expectant mother during pregnancy, bed rest associated with various diseases and complications, excessive weight, obesity;
  • stress, overwork and mental strain of the mother in labor.

What signs characterize weak labor?

Weak labor is characterized by the following symptoms:


  • short contractions of low intensity;
  • too slow movement of the fetus along the birth canal;
  • violation of the rhythm of contractions;
  • slow opening of the uterine os;
  • increasing the intervals between contractive movements;
  • excessive fatigue of the woman in labor;
  • protracted period of labor;
  • fetal hypoxia.

All these signs can be diagnosed only after the birth process has begun. In addition, a distinction is made between primary and secondary weakness. In the first case, one or more symptoms are observed from the very beginning of labor, and in the second, labor begins normally, but then changes in character.

What to do if a woman in labor experiences weak labor?

Health care workers must decide on tactics in each specific situation depending on the condition of the mother and the unborn child.

In the event that the weakness of labor threatens life and health expectant mother and baby, doctors can act as follows:


  • Strengthen labor by opening the amniotic sac. This procedure is called amniotomy. As a rule, it allows the woman in labor to cope with the task assigned to her independently without the use of medicines. However, there are significant contraindications for amniotomy, such as placenta previa or umbilical cord loops, malposition of the fetus, or exacerbation of genital herpes. In such cases, employees medical institution must choose a different tactic to help the expectant mother;
  • If amniotomy is ineffective, labor can be induced with medication. The most commonly used uterotonics here are oxytocin and prostaglandins, as well as putting the patient into medicated sleep after using narcotic analgesics. Usually similar drugs are administered intravenously by installing a dropper, however, in some cases, the woman in labor may be offered a tablet or capsule for oral administration;
  • Finally, in cases where stimulation does not have the desired effect, and also if the woman in labor is completely exhausted or there is serious threat life of the fetus or expectant mother, is produced emergency surgery caesarean section.

If labor is stimulated artificially, the life and development of the child is at risk, so constant monitoring of the condition of the unborn baby is required using a heart monitor.

Measures to prevent weak labor

As you know, any pathology is much easier to prevent than to treat.

That is why throughout pregnancy, and especially after the 36th week, a number of measures should be taken that will reduce the likelihood of a weak labor process, including:


  • in order to increase the energy potential of the uterus, it is recommended to take a complex of vitamins for pregnant and lactating women, containing folic and ascorbic acid, as well as B vitamins;
  • eat properly and nutritiously, follow a daily routine, sleep at least 8 hours a day;
  • psychologically prepare for childbirth, if necessary, attend special courses.

The reasons for weak labor can be different and in some situations it cannot be predicted.