The dissertation is devoted to reducing the frequency of obstetric and perinatal complications in healthy women by optimizing prenatal training based on the study of predictors of labor anomalies, determining the thresholds of pain sensitivity, personal and situational anxiety, stress-limiting and stress-implementing systems.
On the basis of a retrospective analysis, the features of the course of pregnancy, childbirth, the postpartum period and perinatal results of delivery of healthy primiparas were studied.It was established that pregnancy in primiparous women is accompanied by a significant number of complications, namely, the threat of termination, anemia, early gestosis, asymptomatic bacteriuria, gestational pyelonephritis of pregnant women, hypertension. During childbirth, these women showed a high rate of abnormalities in labor, premature rupture of membranes, fetal distress, operative delivery, and a low assessment of newborns on the Apgar scale. The postpartum period was complicated by defects in the placenta and membranes, rupture of the cervix and perineum. The frequency and main variants of labor anomalies in these women have been established, namely: weakness and discoordination of labor.
It was determined that during pregnancy and childbirth, healthy primiparous experienced psychoemotional stress, which caused changes in situational and personal anxiety, most pronounced in the active phase of childbirth.
The nature of changes in the indicators of stress-implementing and stress-limiting systems in the active phase of labor was studied and a correlation was established with indicators of the psychological state, which made it possible to deepen the existing data on the pathogenetic mechanisms of abnormalities in labor and the development of perinatal pathology. The nature of the pain syndrome in childbirth was determined and the methods of anesthesia were applied in healthy primiparous.
It was found that partner childbirth reduces psychological stress and improves the indicators of stress-implementing and stress-limiting systems in healthy primiparas, increases the pain threshold, while maintaining a high level of personal and situational anxiety, a high level of cortisol and a significant part of women who rated pain as severe and intolerable, which necessitated further improvements in antenatal training.
An algorithm for prenatal preparation in healthy primiparous was developed and implemented, including: psychophysical training, partner support, transcranial electrical stimulation of brain structures and the use of magnesium, which improves the psychological state, has a positive effect on the indicators of stress-realizing and stress-limiting systems, increases the pain threshold and threshold pain tolerance.
The proposed algorithm for the prenatal preparation of healthy primiparas helps to reduce the incidence of complications in childbirth and the postpartum period, improve postpartum adaptation, reduce the level of perinatal pathology and reduce the drug load.
