In the case of non-coordinated labor, coordination of the contractions or between different parts of the uterus is broken: the right and left halves of the uterus, between the upper (bottom, body) and the lower uterus, between all parts of the uterus (fibrillation, tetatus of the uterus). This complication occurs in 1-3% of cases.
Causes of discoordinate contractions of the uterus can be:
- Dystocia of the cervix (stiffness, cicatricial changes, atresia, tumors of the cervix);
- Malformations of the uterus (bicorns, saddle uterus, septa in the uterine cavity);
- Clinical mismatch between fetal and pelvic dimensions;
- Degenerative, inflammatory and neoplastic processes in the uterus;
- Discoordination (violation of coordination of contractions between different departments of the uterus);
- Hypertonus of the lower segment (bile gradient)
- Circular dystocia;
- Tetonia of the uterus.
Clinically discordant labor activity is manifested by the presence of painful irregular fights. When palpation of the uterus, there is a different tension in the different parts of the uterus. Often there is an "immature" cervix of the uterus and its slow opening. Discoordination is observed in the first stage of labor before opening the cervix by 5-6 cm. The placental-uterine blood flow is sharply disturbed and hypoxia of the fetus arises.
Analgesics (20-40 mg of promedol), spasmolytics (no-sppa 2 ml, baralgin 5 ml) and sedatives (seduxen 10 mg) are used to normalize labor activity. When fatigued, the mothers give a medical sleep-rest for 2.5-3 hours, prevent fetal hypoxia.