Today, endometriosis still remains a mysterious disease and its causes are not known exactly. But in spite of these circumstances, the researchers found an association between endometriosis and some of the factors that provoke its occurrence. These include numerous abortions and curettage, cervical diathermocoagulation, adverse environmental conditions, family history and more. Gynecologist found that, as a rule, pregnancy, postpartum and lactation lasting beneficial effect on endometriosis, contribute to the process of remission or even complete atrophy of endometriotic lesions. And yet, in some cases there endometriosis after delivery (i.e., the disease is not diagnosed until pregnancy).

Endometriosis

Endometriosis - a benign and progressive gormonalnozavisimyh disease in which cells of the endometrium (lining of the uterus) extend beyond "the provisions of the nature of their location). There are genital (92-94% of cases) and extragenital endometriosis. Endometriosis is often the cause of infertility in women The causes of infertility in women - and the main predisposing factors And a disease that arose prior to pregnancy, complicating its course (the threat of termination, gestosis, anomalies tribal forces, placenta previa, etc.).

Factors that trigger the appearance of endometriosis after childbirth

The factors that lead to disease after delivery include:

• prolonged labor, prolonged dry period;
• Caesarean section (postoperative scar endometriosis, adenomyosis);
• obstructed labor (post-partum bleeding that requires manual control of the uterus, forceps delivery or the birth of a large fetus, leading to obstetric injury);
• perineal tears and episiotomy;
• ruptures of the cervix;
• vaginal tears;
• placenta previa;
• tight attachment of the placenta.

Clinical manifestations

Common forms of endometriosis after childbirth:

• The inner uterine endometriosis (adenomyosis)

Pathological delivery, which is usually accompanied by inflammation of the mucous and muscle layer of the uterus, leading to morphological rearrangement of the endometrium and myometrium. This endometrial cells begin to grow into the interior of the uterus. There are four degrees of spread of the process:

1 degree - the spread of endometriosis at a shallow depth;

2 degree - germination hotbeds of endometrioid endometrial thickness until the middle;

3 degree - is characterized by the involvement of all segments of the uterus;

4 degree - in the process involves the parietal peritoneum and adjacent organs (rectum, bladder).

Clinically adenomyosis uterus Adenomyosis of the uterus - the problem of women forties   It manifested by pain, which are particularly intense in lesions adjacent organs, menstrual cycle disorders (heavy, clotted menses, the emergence of spotting before and after menstruation), reduced reproductive capacity.

• Endometriosis Cervical

Visually endometriosis cervical vaginal part of it found a small quantity of endometriotic lesions with a diameter of two to five millimeters. These pockets have a reddish color, and contrast sharply with the pale pink mucous membrane of the cervix. In the second phase of the menstrual cycle become hotbeds of blue-purple color and some increase in size. Moreover, there is premenstrual and postmenstrual spotting. In some cases, cervical endometriosis is given to the presence of pseudo glands are filled with hemorrhagic content.

• Retrotservikalnogo endometriosis

In this form of endometriosis growth of endometrioid heterotopias noted in pozadisheechnom space. This palpable dense, hummocky and sharply painful fixed nodes. Typically, these units have a small amount, but says their increase before menstruation. For retrotservikalnogo endometriosis characterized by severe pain in the abdomen Abdominal pain: when to sound the alarm? That radiating to the lower extremities, and rectum during defecation. Has black spotting Spotting - it is important to rule out pathology   before and after menstruation. During menstruation marked flatulence, constipation, frequent urination.

Anna Sozinova

Childbirth - a physiological process, but every woman he usually takes in his own way. There are certain limits of physiological norm, going beyond that is considered an anomaly. For such an anomaly in labor are rapid delivery.

How is the physiological birth

Hippocrates believed that the physiological labor lasted no more than a day since the start of labor (18 hours for the first birth and 12 hours for the multiparous). Currently, less labor continues for a long time - it helps to reduce maternal and child injuries.

During physiological childbirth are three periods:

• during the opening of the birth canal, or fights - it goes from 13-18 hours in nulliparous to 10-11 hours in multiparous;
• during the expulsion of the fetus (attempts) - duration of 1-2 hours in nulliparous women to half multiparous;
• successive period - the birth of the placenta - the duration of half an hour both nulliparous and multiparous women.

Why are there rapid birth

"Parturient" the queen is in the contraction of muscles (tone) and increased arousal. The excitability of the uterus - is the property of her muscles to contract under the influence of special substances that are released in the body of a woman giving birth under the influence of the cerebral cortex - the team of their separation comes when the fruit ripens.

There are the normal tone of the uterus, low and high. Increased tone of the uterus is considered a violation of labor. Thus contractions become very strong, prolonged and frequent (more than five contractions in 10 minutes). Considerably shorter becomes the slow relaxation of the muscles of the uterus, they do not have time to rest and recharge energy. Deliveries in that case lasts no more than 1-3 hours, and sometimes less, then overstrain muscles of the uterus affects their complete relaxation (atony).

Such rapid deliveries referred to, they often occur in women with an increased excitability of the total (for example, nervousness, increased thyroid function). In this case violated the regulation of labor on the part of the central nervous system and the impulses coming from the uterus to the brain is insufficient controls its higher parts - the cerebral cortex.

How is the rapid birth

Rapid deliveries begin suddenly, when nothing heralds their beginning. Immediately begin intense, frequent and prolonged struggle, which quickly lead to full disclosure of the birth canal. Woman in labor at the same time are usually too excited, which negatively affects its behavior during delivery, including on the implementation of a team of doctors.

Once depart amniotic fluid, immediately go into battle strong and frequent attempts. Many times women giving birth are sometimes quite isolated attempts to give birth to the baby first, and then the placenta. Often these genera caught a woman in the street, in stores, and where she has to give birth (birth, street).

The dangers that can occur during rapid delivery

With strong and frequent muscle contractions of the uterus blood circulation in the uterus and placenta, the child receives less oxygen and nutrients - it may further affect the state of his brain. With the rapid advancement of the fetal head through the birth canal soft skull bones do not have time to take the desired shape for the passage, with the result that the head undergoes rapid and strong pressure, it can cause birth defects Birth injuries - than they threaten your child?   and intracranial hemorrhage.

A woman like that during childbirth threatens premature detachment of the placenta ruptures of soft tissues of the birth canal (cervix, vagina, perineum), which in turn can cause severe bleeding. In addition, rapid delivery may cause depletion of energy resources muscles of the uterus and its full atony (relaxed). As a result of uterine atony following delivery is not reduced, the blood vessels of the uterus, placenta associated with the department continued to gape - a so-called atonic bleeding, which is very difficult to stop. Rapid genera also promote uterine injury that leads to the development of various diseases in the postpartum period.

How to lead the rapid birth

Maintaining rapid delivery aimed at reducing the activity of labor: the woman in childbirth is laid on its side and general anesthesia. Deliveries take in the status of women on the side. After delivery, a careful examination of the perineum in order to identify gaps.

In the case of "street" after receipt of a woman giving birth in a maternity hospital she was treated carefully vulva disinfectants and administered tetanus toxoid.

If a woman has previously been rapid delivery, then it is usually admitted to the hospital before the due date.

Galina Romanenko