Pregnancy management during pregnancy has its own characteristics. Close attention should be given to pregnant women with risk factors. Timely hospitalization in the maternity hospital is necessary to examine the pregnant woman and decide on the method of delivery. The choice of method depends on many factors: medical history, readiness for childbirth, condition and estimated weight of the fetus, concomitant diseases of the woman.
Surgical delivery is indicated when the fact of overgrowth is combined with such complicating factors as:
• mother's age (30 years and older);
• very large or very small fruit;
• lack of readiness for childbirth - immature cervix, abnormal position of the fetus;
• fetal hypoxia;
• pregnancy after IVF;
• failures in previous pregnancies and childbirth in history.
In a more favorable situation, but the birth canal is not ready, it is necessary to additionally prepare the cervix for childbirth. Various methods are used for this:
• detachment of the lower pole of the fetal bladder from the walls of the uterus;
• balloon dilatation of the cervix using a Foley catheter - allows you to mechanically expand the cervix;
• dilators of natural (kelp) and synthetic origin - have a relaxing effect, promote the production of endogenous prostaglandins in the cervix;
• it is possible to use prostaglandin E or antiprogestogens (Mifepristone).
Childbirth during prolonged pregnancy without signs of overmaturity of the fetus most often proceed without pronounced complications, but require close monitoring of their progress.
Late childbirth with signs of fetal overripeness is often complicated. Therefore, in order to timely resolve the issue of choosing a method of delivery, it is important to assess each period of pregnancy. During conservative childbirth (through the natural birth canal), it is necessary to constantly monitor the condition of the fetus.
For labor induction, you can use amniotomy - an artificial rupture of the membranes of the fetal bladder. It is carried out exclusively with a mature cervix and a good condition of the fetus.
In the postpartum period, it is very important to take preventive measures to prevent bleeding, which may occur due to the peculiarity of the structure of the uterus, retention of parts of the placenta, rupture of soft tissues and impaired hemostasis (blood clotting system). To do this, a thorough examination of the birth canal is carried out to detect ruptures, accounting for blood loss, clinical and laboratory monitoring of blood tests and the use of uterotonics, which stimulate uterine contractions.