Gaps during childbirth are frequent complications. They arise mainly in primiparous women. Consider this violation in detail, highlighting the causes of development, ways of prevention and treatment of pathology, features of the recovery period.
Why do ruptures occur during childbirth?
Discontinuities after childbirth occur in about one in every three women in labor. At the birth of the first-born, the complication develops more often. This is often due to the unpreparedness of the birth canal. The muscles of the pelvis and the perineum with the fetal move undergo strong pressure, which is what causes the development of muscular structures. Often gaps are recorded during rapid childbirth , when the exile phase lasts several minutes. Among the provoking factors of this violation it is customary to allocate:
- the first-born at the age of 30 years and older - these women have a sharp decrease in the elasticity of soft tissues;
- scar changes on the perineum after previous births;
- fast, rapid delivery;
- insertion of the head of the fetus in the extensor position (the head of the baby is not the smallest);
- pelvic presentation - the baby appears from the birth canal path or foot forward;
- violation of tactics of delivery;
- Execution of surgical interventions at delivery - application of forceps, vacuum extraction of the fetus , manual separation of the afterbirth;
- large fruit.
Perineal rupture during childbirth
Childbirth without pain and rupture is a rare occurrence. Violation of the integrity of the birth canal occurs because of excessive pressure on the soft tissues that the fetus exerts. At the same time, the development of a rupture is preceded by signs that help prevent a complication. Obstetricians must pay attention to the protrusion of the perineum, and its cyanosis, which arises from the venous stasis in the small pelvis. The edema of tissues develops, the skin in this area acquires a characteristic luster. In the absence of appropriate measures, ruptures occur during childbirth.
To prevent the complication of the delivery process, midwives carry an episiotomy or perineotomy. These manipulations involve the dissection of soft tissues in the region of a developing rupture. So you can exclude the possibility of infection. In addition, the dissected wound heals faster than the ripped wound. The rupture of the perineum after childbirth can be scarred within a month, and the sutures after the cut are removed already for 7-10 days.
Vaginal rupture during childbirth
Gaps during labor significantly complicate the course of the process of appearance of the baby. The integrity of the vagina is disturbed when the baby's head does not move along the birth canal, being long in one position. To provoke the development of the gap may also premature attempts. As a result, bleeding develops, which begins in the tardy period. In this case, hemorrhage can occur under the mucous membrane of the vagina. In this situation, the complication is recorded already when examining the birth canal after childbirth.
Cervical rupture during childbirth
Due to the fact that each woman in labor has a different pain barrier, attempts are felt by them in different ways. If the taut reflex develops, when the cervix has not yet fully opened, and the woman begins to push, there is a neck rupture. The head of the baby exerts a strong pressure, because of the resulting resistance of the neck, which is not fully opened. As a result, the integrity of the genital organ also deteriorates.
Rupture of the cervix after childbirth requires an early suture. There is no need for anesthesia. In the course of manipulation, doctors use self-permeable strands. As a result of healing on the neck, a postoperative scar is formed. In order to rule out a repeated rupture in subsequent births at the same place, a planned cesarean section is prescribed.
Rupture of the uterus on the scar during delivery
Rupture of the uterus during childbirth often occurs on the existing scar. If earlier the tissues of the birth canal were subjected to surgical interventions, a site of connective tissue with less elasticity is formed at the site of their dissection. Immediately here there is a violation of the integrity of the body. The development of complications of this kind is facilitated by:
- surgical operations on the genitals in the past;
- presence of caesarean section in the anamnesis.
Gaps at delivery - consequences
Physicians always try in a short time to eliminate the cervical rupture during childbirth, the consequences of which can negatively affect the health of the mother in childbirth. This complication is accompanied by abundant blood loss, which leads to death in the absence of medical care. However, late complications associated with the process of restoring the reproductive system are also possible. Among them are:
- abscesses in the place of suturing;
- wound infection;
- hematomas;
- inflammatory processes;
- formation of scars.
How many ruptures heal during childbirth?
This issue is of an individual nature. The speed of regeneration processes depends on a number of factors - the size of the rupture, its localization, whether it is single or multiple. Immediately, these factors are evaluated by physicians in the course of restorative therapy. Stitches at ruptures at delivery are removed depending on what material was used. So, the outer ones are removed already on the 7-10th day from the moment of their superposition, the internal ones dissolve themselves, the doctors only observe their disappearance.
With regard to the timing for which the full healing of the wound, they are also different. Thus, internal gaps during childbirth heal in about 14 days, with the seams finally resolving within a month. External perineal injuries heal after removing the joints 3-4 weeks. The process itself can be delayed by joining the infection, suppuration, which requires additional therapy and time.
How to avoid gaps during childbirth?
Often, worrying about the upcoming appearance of the baby, pregnant women are interested in doctors how to avoid ruptures during childbirth. Doctors do not give an unambiguous answer pointing to the need for an integrated approach. Preparatory measures aimed at reducing the risk of complications during childbirth include:
- learning the right technique of trying ;
- Exclusion of inflammatory processes in the reproductive system;
- performing perineal massage;
- performing special physical exercises for training the muscles of the perineum and the vagina.
How to prepare for delivery without breaks?
Births without breaks are one of the goals pursued by doctors in prenatal training. It begins directly with the conversation, parsing the stages and the mechanism of birth. As a result, a woman understands what to do and how to behave in the process of delivery in order to avoid complications. At the same time, examinations are performed to exclude inflammations and infections in the reproductive system (strokes from the vagina and urethra, bacterial culture). The next step in the preparatory process is to increase the elasticity of the perineal tissues. This is achieved by:
- massage of the given area;
- performing physical exercises.
Remedies for ruptures during labor
Oil for the prevention of ruptures during labor helps to reduce the risks of this complication. Use it to carry out a massage. You can begin the procedure almost at any time. So, at the beginning of pregnancy and in the 2nd trimester, massage is done once every 7-10 days. Starting from week 28, the frequency of the procedure is increased to 1 time in 5-7 days, after 32 weeks - 1 to 3-5 days. As you approach maternity, manipulation is even more frequent - at 36 weeks every other day, from 38 daily. At the same time for the manipulation use such oils as:
- chamomile;
- olive;
- pink;
- calendula.
There are also special pharmaceuticals designed to increase the elasticity of the birth canal, eliminating ruptures in childbirth. Among the known can be identified:
- Peri oil;
- Weleda.
It should be borne in mind that these procedures have their contraindications, so it should only be done after agreement with the gynecologist. Massage is prohibited when:
- infectious-inflammatory processes in the vagina;
- the threat of abortion;
- skin diseases of the perineum;
- elevated body temperature.
How to avoid ruptures during labor - exercises?
Prevention of ruptures during labor involves the exercise of physical exercises aimed at training the muscles of the perineum and pelvis. They help to improve the elasticity of the muscular structures, resulting in a reduced risk of birth complications. Gynecologists recommend the following exercises:
- In standing position, raise your knees as high as possible, bringing them to your chest.
- Maximally stretch your legs back, placing emphasis in the back of the chair.
- In the supine position on the side, drawing in the sphincter of the rectum, several flaps perform a straight leg.
- Putting his feet with his toes outward, wider than his shoulders, do deep squats, lingering in the bottom position for a few seconds.