Clinical aspect of the delivery course in women in labor who chose the alternative method of delivery

The issue of preserving the health of the woman in labor and the fetus, and later – the newborn, is one of the most priority tasks of modern obstetric service. Today, a feature of modern obstetric care in Ukraine is its transition to patient orientation, which determines not only a modification of management of pregnancy and childbirth, but also the creation of comfortable and safe conditions for the mother and newborn. There is also a tendency to increase the demand from future pregnant women and women in labor for “non-traditional” non-medicinal methods of pain relief and alternative approaches to childbirth, which are focused on reducing the severity of labor pain without the use of medical devices, ensuring free movement during childbirth, creating psychological comfort and a positive childbirth experience for the woman in labor and her partner.The objective: to evaluate the course of childbirth in women in labor who were involved in an attempt to give birth in water.Materials and methods. The study involved 150 pregnant women, who, depending on the proposed delivery method, were divided into:main group (MG) – 66 pregnant women, in whom delivery took place with the use of hydrotechnologies in the first and second stages of labor;comparison group (CompG) – 34 pregnant women, in whom delivery took place with the use of hydrotechnologies only in the first stage of labor;control group (CG) – 50 pregnant women, in whom childbirth took place according to generally accepted standards.Additionally, in the dynamics of the first stage of labor, all women in labor were assessed for the intensity of labor pain using a visual analog scale (VAS).Results. In the dynamics of labor, rupture of the fetal membranes occurred with greater cervical dilation against the background of satisfactory progress of labor in women in labor with the use of hydrotechnologies (MG – 8.6±0.3 cm, CompG – 8.1±0.4 cm, CG – 5.6±0.3 cm; p<0.05). Moderate intensity of labor pain persisted in the first stage of labor when the cervix was dilated by 6–7 cm in women in labor with the use of hydrotechnologies (MG – 56 (84.8%) women in labor, CompG – 29 (85.3%), CG – 15 (30.0%); p<0.05). Women in labor with CG had severe pain – 14 (28.0%) and unbearable pain – 11 (22.0%), which was an indication for the use of pharmacological analgesia methods in the first stage of labor.At the end of the first stage of labor, the vast majority of women who chose water birth as an alternative approach to labor management had a tendency to maintain the intensity of labor pain, which was assessed by VAS at 4–6 points: MG – 48 (96.0%), CompG – 24 (96.0%), CG – 34 (68.0%) women; p<0.05. Severe labor pain, assessed at 6–8 points, was complained of by 31 (32.0%) CG women, 2 (4.0%) women in MG, 1 (4.0%) – CompG (p<0.05).Conclusions. The positive effect of the use of hydrotechnologies during childbirth is confirmed by the presence of a significantly lower number of complications requiring surgical delivery in the first (MG – 3 (5.6%) women, CompG – 2 (7.4%), CG – 20 (28.6%) and second stages of labor (fetal distress: MG – 2 (4.0%) women, CompG – 4 (16.0%), CG – 8 (16.0%); p<0.05); weakness of labor activity that is not amenable to medical correction was not detected among parturients in MG (CompG – 2 (8.0%) persons, CG – 4 (8.0%) women; p>0.05). Due to existing complications during the second stage of labor, there was a need to use surgical delivery by applying a vacuum extractor (MG – 2 (4.0%), CompG – 6 (24.0%), CG – 12 (24.0%) women; p<0.05). The results of the study demonstrate the effectiveness of childbirth with the use of hydrotechnologies in low-risk pregnant women in reducing the level of obstetric complications, and, as a result, this is reflected in a significantly higher number of cases of physiological delivery (MG – 39 (78.0%), CopmG – 14 (56.0%), CG – 27 (54.0%) women in labor; p<0.05).