[Reflex analgesia in the combined treatment of pregnant women with a pathological preliminary period]

The impact of reflex analgesia via transcutaneous electrical neurostimulation and electrical acupuncture was studied in 46 patients with an abnormal preliminary period by using tests of pain sensations and personal and reactive anxiety, ECG, hysterography, and computer-aided prediction of labor complications. Reflex analgesia was found to contribute to effective abolishment of preliminary pain sensations, to normalization of central nervous system function, autonomic reactions, uterine contractility, to reduction in pharmacological agent use and treatment duration, and to better delivery.

Nipple stimulation for labor augmentation

A randomized, prospective study was undertaken to evaluate the efficacy of nipple stimulation with a breast pump as compared to oxytocin for augmentation of labor. The average and maximal uterine activity achieved was significantly higher in the oxytocin-stimulated group, without significant differences in the length of labor stages, cesarean section rate, Apgar scores or umbilical artery pH. Fifty percent of the patients failed to respond to nipple stimulation after 30 minutes and were switched to oxytocin. These patients experienced a more rapid rate of cervical dilation in the active phase and reached higher maximal uterine activity with oxytocin stimulation; however, the cesarean section rate was highest in this group. Nipple stimulation with a breast pump appears to be a safe and effective alternative to oxytocin for the augmentation of labor.

[Electrostimulation of the uterus in uterine inertia]

The paper provides the results of electrostimulation application to the therapy for uterine inertia. Monopolarization current action on the cervix was shown to be beneficial in 83.34% females with abnormal labor. No negative effects of the method was found on the status of a fetus and a parturient.

[Changes in the biochemical indices of parturients with uterine inertia against the background of therapy]

A comparison was made of some biochemical parameters for energy metabolism, acid-base balance, blood gases and uterine contractility in parturients with uterine inertia who were on therapy with or without hyperbaric oxygenation. The presence of hypoxemia and metabolic acidosis in the parturients was found to intensify the processes of lipid peroxidation, to affect the functional status of myometrial biomembranes, to result in hyperenzymemia and disturbed tissue metabolism and lower myometrial contractility. The use of hyperbaric oxygenation in the multimodality therapy for uterine inertia was ascertained to eliminate oxygen deficiency, to increase tissue respiration, contributing to normal labor.

Postpartum hemorrhage

Postpartum hemorrhage is usually unexpected, and blood loss can be massive. Excessive bleeding after delivery may result from uterine atony, disruption of the genital tract, placental abnormalities, coagulation disorders and miscellaneous obstetric complications. Prompt treatment is imperative. Treatment options include oxytocics, prostaglandins, uterine exploration, uterine packing and, occasionally, surgery.

Neurology and behaviour of newborn infants delivered by vacuum extraction on maternal indication

23 full-term neonates delivered by vacuum extraction (VE) on maternal indication (primary or secondary uterine inertia) but with no sign of fetal asphyxia and a control group of 16 infants were studied. The infants were examined on the 1st and 5th days after birth with the Brazelton Neonatal Behavioural Assessment Scale and by a standardized neurological examination. On day 1 the VE-infants showed lower visual and auditory responsiveness in the behavioural assessment, and fewer optimal responses in the neurological examination than did the controls. Obstetrical factors such as abnormal presentation, long duration of the second stage of labour, and long duration of VE (greater than or equal to 15 minutes) may explain the differences. The differences between the groups had largely disappeared by day 5.

[Treatment with electric stimulation]

The author presents various electrostimulation techniques that have been applied with good results for triggering and stimulation of parturition, preventing secondary adynamia of pharmacologic analgesia at birth, for analgesia and sedation during childbirth, for the treatment of hypertensive dysgravida, for postoperative analgesia, and the prophylaxis of dynamic ileus, for the treatment of postoperative dynamic ileus and for the therapy of chronic pain. The electrostimulation technique is applied with several devices that deliver pulse currents of various form with a frequency between 1 and 250 Hz and intensities between 1 and 40 mA, through 2, 3 or 4 transcutaneous electrodes. The electrostimulation techniques can be applied as current therapeutical methods, or can be used as reserve therapy in various specialties. They are economical, easy to perform, and protect the patient against toxic, allergic, and genetic side effects of pharmacologic therapy.