Obstetrics and Gynecology - A.M. Gromova 2000

Uterine Contractile Dysfunction
Classification of Labor Abnormalities
Pathological Preliminary Phase

The physiological preliminary period lasts for 6 hours. Women complain of irregular contractions, lower back pain, and frequent urination, while the pregnant woman's Sleep pattern remains undisturbed. A gradual increase in the intensity and frequency of preliminary pain is observed, transitioning into regular labor contractions accompanied by the gradual effacement and dilation of the cervix.

The pathological preliminary period ranges from 6 to 48 hours or more. Women likewise report pain in the lower abdomen and back, along with irregular contractions. However, in the case of a pathological preliminary period, there is no progressive cervical dilation, the pregnant woman's psycho-emotional state is impaired, fatigue sets in, and signs of fetal distress emerge.

Management: administration of one of the antispasmodics (No-Spa 2 ml, papaverine hydrochloride 2%–2 ml, baralgin 5 ml) intramuscularly or intravenously. Concurrently, therapy aimed at cervical ripening is administered: establishing a glucose-vitamin-estrogen-calcium Background, or the vaginal application of Proстин E2 (dinoprostone) gel, or Prepidil gel for intracervical use. In prolonged pathological preliminary periods, when the expectant mother is fatigued and the pain persists, it is necessary to administer, In addition to antispasmodics, 10 mg of seduxen, 50 mg of pipolphen (2.5%–2 ml), and 20 mg of promedol (1%–2 ml) intramuscularly. If the woman does not fall asleep, 10–20 ml of a 20% sodium oxybutyrate solution should be administered intravenously. Therapeutic sleep and rest are managed by the anesthesiologist.

Following the pharmacologically induced rest, 85% of women awaken in the active phase of labor, which proceeds without labor anomalies. In 10% of pregnant women, contractions are absent after sleep, and in 5% secondary uterine inertia develops, with contractions remaining weak, indicating The Need for Management of Labor dystocia. Amniotomy yields beneficial results, particularly in cases of polyhydramnios or oligohydramnios.



Last update: 08/08/2026

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