Reduction of obstetric injuries by increasing of the birth canal elasticity

Abstract

The objective: to evaluate the therapeutic effect of a vaginal gel containing hyaluronic acid and decamethoxine for the prevention of obstetric injuries reduction of the birth canal during childbirth, as well as to improve the course of the postpartum period.Materials and methods. An analysis of the course of vaginal births in the fetal head presentation of 500 births that took place in the communal non-commercial enterprise «Kyiv City Maternity Hospital No. 2» during 2021–2022 was carried out. The main group included 250 pregnant women who were given a vaginal gel containing decamethoxine, sodium hyaluronate and lactic acid during childbirth and in the postpartum period. The comparison group consisted of 250 pregnant women who did not use the specified gel during childbirth and in the postpartum period.Results. The average age of patients in the main and the comparison group was 28.92±1.32 and 27.17±1.56 years, respectively. In both groups, primiparous women prevailed – 157 (62.80%) persons in the main group, 158 (63.20%) – in the comparison group, 93 (37.20%) and 92 (36.80%) women had the second labor respectively. There was a tendency to decrease the time of the second period of labor in women of the main group compared to the comparison group. The frequency of episiotomy was 1.63 times lower in the main group than in the comparison group (p<0.05), the rate of soft tissue injuries in childbirth – 1.32 times lower (109 (43.60%) and 144 (57.60%) women respectively; p=0.002).During the week of the postpartum period, the number of patients with discomfort in the vagina and perineum was 2.49 times less in the main group (59 (23.60%) persons) than in the comparison group (147 (58.80%) women; p<0.001), with pain – 1.85 times (88 (35.20%) and 163 (65.20%) individuals respectively; p<0.001). 132 (52.80%) women of the comparison group complained on the limitations in their daily activities due to the mentioned symptoms, which was 2.16 times more than in the main group (61 (24.40%) persons; p<0.001).Conclusions. The use of vaginal gel, which contains hyaluronic acid and decamethoxine, during childbirth and in the postpartum period for prevention of obstetric injuries and improvement the course of the postpartum period is effective, which led to a 1.32-fold decrease of women with vaginal and perineal tears (p<0.05) and 1.63 times – the frequency of episiotomy (р<0.05) and improvement of the course of the postpartum period.