Шляхи зниження частоти кесарева розтину в умовах типового міського пологового будинку

Abstract

The objective: Study ways to reduce the frequency of cesarean section (CS) in a typical urban maternity hospital. Patients and methods. In the course of the study, the history of the delivery of women of a typical urban maternity home was studied and analyzed, the birth of which was completed by holding a COP for the period from 2001 to 2014. Results. According to the analysis, the number of births has steadily increased every year: from 2.082 in 2001 to 4.655 in 2014. However, during a careful study of the structure of labor during the study period, a wave-like increase in the percentage of CS was noted from 17% in 2001 to 21.25% in 2008, followed by a positive trend of its decline - to 17.8% in 2014. In the conditions of the study, the structure of the most common indications from the mother and the child for conducting operations of the COP was established. The leading place among the testimony from the mother was the scar on the uterus. This indicator increased from 6.6% in 2001 to 36.3% in 2014, that is, almost 5 times. So, in modern obstetrics, it remains an important problem to find ways to reduce the number of scars on the uterus as the main indication for CS operation. Conclusion. 1. The delivery of women with a vaginal scars on the uterus is a reserve for reducing the percentage of Caesarean section (CS), reducing blood loss, more physiological delivery, rapid post-natal adaptation of newborns, and restoring the woman in labor after the delivery. 2. Women with a pathological preliminar period constitute a high-risk group for the development of abnormalities of labor. Therefore, there is a need to create and implement algorithms for managing women with a pathological preliminar period. 3. In the presence of polyhydramnios or lack of water it is necessary to carry out careful monitoring of women in labor, to react promptly and immediately to changes in the nature of labor. 4. To reduce the number of abnormalities of labor, it is necessary to develop new criteria for the selection of candidates for rhodostimulation and the introduction of integrated approaches to assessing the «maturity» of the cervix. 5. The reserve for reducing the frequency of CS after ART is, of course, a group of patients whose cause of infertility is the male factor and the somatic anamnesis is not burdened and pregnancy is characterized by a favorable course, as well as patients younger than 30 with tubal peritoneal infertility in the history of Uncomplicated pregnancy. Key words: c-section, scar on the uterus, abnormal labor, assisted reproductive technologies.