Pathologies/development | Contractions

Pathologies/development

Pathologies at birth are disorders of the contractions with a resulting abnormal birth process (contractions dystocia). Normo/hypotonic weakness of the contractions is defined as too short (less than 20 seconds), too rare (less than 3 contractions per 10 minutes) and/or too weak (less than 30mmHg) contractions. The basal tone may be normal or reduced.

If the weakness of the contractions exists from the beginning of the opening period, it is called primary weakness of the contractions. Causes of this are drugs, especially sedatives or general anaesthetics (narcotics) or a so-called dystopic arousal. This means that the muscular contractions of the uterus do not originate from one center and are therefore coordinated and strong, but uncoordinated from several centers and therefore not as strong.

However, these contractions can still develop into coordinated contractions in the course of birth. If the weakness of the contractions occurs only during the opening or expulsion period, this is called secondary or fatigue contractions. The main causes of this are overstretching of the uterus, e.g. in twins, large children or too much amniotic fluid (=polyhydramnios) or a prolonged (= protracted) birth process.

Risk factors for prolonged birth are a too small pelvis or malformations of the mother’s pelvis or anomalies in the position, attitude (= turning of the body into the birth canal) and posture of the child. However, a simple cause of the inhibition of contractions is also a full bladder or cold feet. Hypertonic weakness in labor: The contractions occur regularly or slightly more frequently, with normal strength and duration.

However, the pressure in the uterus (=basal tone) is increased to over 15mmHg, so that the effectiveness of the contractions decreases. This is usually caused by uncoordinated uterine contractions. Due to the increase in pressure, the blood circulation in the uterus is reduced and there is a risk of oxygen deficiency (=hypoxia) in the fetus.

Contraction storm: This is understood to be too strong (more than 50 mmHg) or too frequent (more than 5 contractions per 10 minutes) contractions. The basal pressure of the uterus is normal. The development of the storm is usually caused by obstetric mechanical problems, such as an imbalance between the size of the child and the pelvic width or postural/positional anomalies.

Too high a concentration of oxytocin (see above for effects) can also be the cause. This can be caused by an overdose, but also by the body’s own increased secretion, e.g. by artificial amniotic sac rupture (=amniotomy) or by overstretching of the uterus. During the storm of contractions, there is increased pressure in the uterus, which can lead to a lack of oxygen for the child.

There is also the danger of the uterus tearing (= uterine rupture).Other pathologies: Premature labor: Preterm labor is defined as attempts to give birth before the completed 37th week of pregnancy, i.e. up to and including 36 + 6 by incipient labor activity. This is the limit of preterm birth. The causes for the occurrence of premature labor are manifold.

Infections are most frequently involved. These can be generalised infections (such as urinary tract infections) or fever, but also local infections such as inflammation in the vagina (=colpitis), in the cervix (=cervicitis) or in the uterus directly (=intrauterine). This topic might be of interest to you: Inhaling contractions Psychological or even physical overload is also mentioned as a reason.

A high risk is also associated with a multiple pregnancy or problems with the placenta, which can be either placental insufficiency or placental abruption. An excessive amount of amniotic fluid (=polyhydramnion) can also be considered as a cause. Post-operative contractions: If an operation is necessary during pregnancy, e.g. in the case of appendicitis, the stress can then trigger contractions. Depending on the week of pregnancy, preventive contractions may be necessary or useful.