Pain during childbirth, Inspection of the first-pregnant, Сontractions, Uterine opening, Analgesia ©
Examination of the primigravida, contractions A primigravida was admitted to the maternity hospital, who did not undergo physio-psycho-prophylactic training. The beginning of the first stage of labor was established . Blood pressure is normal, in such a situation, Seduxen, belonging to the ataractic group, can be used to obtain a sedative effect. Two milliliters of a half-percent solution, 10 milligrams, is administered intramuscularly. It can be administered intravenously in a glucose solution, it is advisable to use Aprofen and Noshpa, they have an antispasmodic effect on the cervix and, in addition, Aprofen increases the contractile activity of the uterus. The contractions of the pregnant woman are frequent, but the behavior has become calm. When opening the uterine pharynx by four centimeters or more, you can conduct a mixture of 20 milligrams of Dimedrol and 20 milligrams of Promedol in a glucose solution. The combination of the ataractic "Seduxen" with the central analgesic "Promedol" is called ataralgesia. This woman in labor began at two o'clock in the morning, she did not sleep, she was tired, the contractions became less frequent and somewhat weakened.
Before deciding on the need for labor stimulation, it is necessary to provide the woman with rest. It was decided to do this with steroid anesthesia. "Viadril" has a pronounced anesthetic effect, leading to sleep within two to three hours . 500 milligrams of "Viadril-G" is diluted with 10 milliliters of a quarter percent solution of novocaine and administered intravenously quickly. To obtain an analgesic effect, premedication with "Promedol" with "Dimedrol" is necessary "Viadril relaxes the striated muscles, but provides good contractile activity of the uterus and rapid opening of the uterine os. With steroid anesthesia, it is necessary to monitor the condition of the woman in labor during sleep.
Contractions continue and intensify, the fetal heartbeat does not change. By the beginning of the attempts, the woman in labor wakes up, a child is born without signs of respiratory depression. This woman in labor at the end of the first stage of labor , the contractile activity of the uterus, which is recorded by the device, is good. The opening of the uterine os is 8 centimeters. By the end of the first, at the beginning of the second stage of labor, it is undesirable to administer analgesics by injection, since their concentration by the time the child is born may remain high and cause respiratory depression in him, it is more advisable to use inhalation autoanalgesia. The most common is the inhalation of nitrous oxide with oxygen using the NAPP-60 or Avtonarkon devices. The dosimeter shows oxygen concentration, nitrous oxide supply is limited to 75 percent. Its concentration can be changed individually for each woman in labor.
Here is another woman at the end of the first stage of labor. A woman in labor is trying to push, but premature attempts will tire her and can cause disturbances in the placental circulation. Anesthesia should be done by inhalation. In addition to nitrous oxide, you can use Pentran or Trilene. Pentran at a concentration of 5.8 volume percent provides good analgesia. A simple gas-air inhaler "Trilan" is used, which a woman uses only during a fight. The gas is rapidly eliminated from the body after the cessation of autoanalgesia..
