Laminaria sticks in gynecology: forgotten old
April 12, 2012
One of the problems faced by obstetricians, is the expansion of the cervical canal. The mechanical expansion of the cervix leads to its rupture, the formation of cervical incompetence, and as a result, to the miscarriage
Miscarriage - why you lose the most precious thing?
. The expansion of the cervix before labor induction prostaglandin drugs fraught with development of abnormalities of labor, preterm rupture of membranes, and even intrapartum (during labor) fetal death. Laminaria sticks in gynecology and obstetrics were used several decades ago, have been unjustly forgotten, but re-gaining its position in obstetric practice.
Sticks Laminaria (from the Latin Laminaria digita, Laminaria japonica, which means seaweed) - a product that is produced from the stem of kelp, which is a natural cervical dilators. Laminaria sticks tight and stiff, their length of 5-6 cm and a thickness ranging from 2 to 10 mm. Their main feature is the ability to grow in the transverse size of three to four times due to the attraction and absorption of fluid in contact with in a moist environment.
Algae, which are produced from laminaria stick, grow in the cold northern seas and the Sea of Japan.
Indications for use
The expansion of the cervical canal using laminaria sticks held in the following situations:
- cervical preparation for childbirth (especially if you have a tight neck and non-stretch);
- preparation of the cervix for labor induction in cases of complicated pregnancy (Rh-conflict, severe preeclampsia, intrauterine growth retardation, fetal death);
- expansion of the cervical canal before intrauterine manipulation (abortion, diagnostic curettage
Scraping - heavy and unsafe procedure
- "Maturation" of the cervix prior to termination of pregnancy for more than twelve weeks.
Based on what action rods kelp?
The mechanism of action of laminaria sticks are still not completely understood. Researchers are inclined to think that the expansion of the cervical canal into play two fundamental factors. The first factor based on the high hygroscopicity rods kelp, causing them to thicken and produce a mechanical pressure on the walls of the cervical canal and its extension. The second factor - the ability of laminaria sticks to influence the formation of uterine prostaglandin F2a and increase its production. Uterine prostaglandin F2a formed from arachidonic acid, which is included in a certain amount of the sticks. Prostaglandins, is produced under the influence of hard sticks kelp, contribute to the expansion and softening of the cervix.
Route of administration
Before the introduction of laminaria sticks must be treated with antiseptic solutions vagina and cervix
. Is introduced into the vagina mirror, the cervical canal is probed, if necessary (in cases of inflection of the uterus or the presence of crimped cervical canal)
. The cervix is fixed bullet forceps
. Laminaria stick grip clip from the end of the thread which runs required for removal
. Before administration into the cervical canal, moisten laminaria stick (e.g., saline)
. The sticks are introduced into the cervical canal parallel to each other, so that they are tightly filled with the cervical canal
. Introduction sticks made to the internal os of the cervix, wherein the ends extend slightly beyond the external os
. To avoid spontaneous expulsion (loss) sticks from the cervical canal, the outer shed a few folded sterile uterine tissue
Before the abortion up to 12 weeks, administered from one to four sticks for the period from six to sixteen hours. If you plan to abortion in the later stages, laminaria sticks entered twice.
Side effects and complications of the introduction of sticks
After the introduction of laminaria sticks, some patients feel discomfort and minor pain in the abdomen
Abdominal pain: when to sound the alarm?
. There may be bleeding
Spotting - it is important to rule out pathology
. Complications include the opening of the fetal membranes and the outpouring of water, getting sticks into the uterine cavity.
Rigevidon - side effects are unlikely
February 21, 2010
Among the modern methods of contraception
Contraceptive Methods: Ten myths about contraception in the mirror of facts
hormonal contraceptives provide the highest guarantee of protection from unintended pregnancy - about 99%. Therefore, many women prefer to use it hormonal contraceptives, despite the risk of weight gain, hormonal imbalances and other "horror" that is credited with artificial hormones. However, the correct choice of medication and strict adherence to medical recommendations such troubles are unlikely. Besides hormonal contraceptives are very convenient to use, as they are consumed orally. One of these oral contraceptives is rigevidon.
The composition of Rigevidon contains two active substances, which, at first glance, are antagonistic towards each other. So, levonorgestrel has a significant contraceptive effect due to the simultaneous exposure to several links in the mechanism of pregnancy.
- Firstly, this hormonal ingredient inhibits the secretory activity of the hypothalamus, necessary for the normal maturation of eggs in the ovaries.
- Secondly, levonorgestrel intravaginal increases the viscosity of the liquid, which is why the male sex cells are not able to overcome this "barrier" and die.
- Third, because of levonorgestrel inhibited growth of uterine lining - the most important stage in the preparation of the endometrium for pregnancy, without which the fertilized egg will not be able to gain a foothold in the uterus.
However, the second component rigevidon - ethinyl estradiol - on the contrary, contributes to the proliferation of the uterine lining and stimulates the production of hormones of female sexual sphere. Such seemingly mutually exclusive action does not reduce the ability of contraceptive Rigevidon, but allows it to be used not only for the prevention of pregnancy but also for the treatment of various menstrual irregularities: excessive or insufficient amount of bleeding, menstrual cycle changes, disorders of menopause, etc. Rigevidon also indicated for painful menstruation, uterine bleeding
Uterine bleeding outside of menstruation - a sign of a serious breach
and in some other cases.
If the purpose of the application is to prevent an unplanned pregnancy, the drug begin to eat on the fifth day from the beginning of discharge. The daily dose is one tablet once per day. It is desirable to establish a permanent, the most convenient time of reception (better in the evening). It should be remembered that the interval between receptions of more than 35 hours does not guarantee an effective contraceptive action. Therefore, in case of missing the timely reception of tablets the next dose should be doubled. Some experts believe that this may not be enough, and recommend further resort to mechanical contraception.
The total duration of receptions is 21 days, that is one cycle. After the completion of one cycle of making a seven-day break, and start the next cycle. This scheme provides a reliable contraceptive effect, especially with prolonged use Rigevidon
Rigevidon - not recommended for women after forty
. However, with prolonged use can not forget the need for periodic medical monitoring, including mandatory testing of functional activity of hepatic glucose
Glucose: The energy source
, blood pressure, blood coagulation, as well as the smear from the cervix. This is mainly due to the fact that the long-term use of Rigevidon possible side effects such as jaundice, reduced absorption of sugar by cells, increased blood pressure, thrombosis, a violation of the composition of the vaginal microflora. Typically, medical monitoring is carried out twice a year. These side effects occur rarely. The most common symptoms occurs, which is observed in the initial stages of reception rigevidon: nausea, vomiting, weight gain, suppression of sexual desire, seal areolas. In most cases, after a few months, these effects disappear.
Some drugs are able to neutralize the effect of contraceptive Rigevidon, so before using any new medication should consult a physician.