Objective: to study the role of neurohumoral and biochemical changes in the pathogenesis of prolonged second stage of labor.Material and methods. To achieve the above objective, we examined 35 parturient women with prolonged second stage of labor and 45 parturient women with physiological labor. We studied the levels of progesterone, estradiol, relaxin, serotonin, cholesterol, thiobarbituric acid reactive substances (TBARS), total antioxidant capacity of plasma, products of final protein oxidation, as well as the total concentrations of nitrite and nitrate ions (NOx) in blood plasma.Results. In the women with prolonged second stage of labor, the levels of estradiol and progesterone were significantly higher than in those with physiological childbirth (p1 = 0.037, p2 = 0.029). The women giving birth by operation had higher estradiol (p = 0.017) and progesterone (p = 0.07) levels than those giving birth physiologically. The level of relaxin was lower in the women with prolonged second period of labor than in those with physiological labor (p = 0.084), especially in the case of operative delivery (p = 0.041), the risk of which increases 4.1 times when the relaxin concentration is less than 36.4 ng/l. Compared to the patients giving physiological childbirth, the patients with prolonged second stage of labor who delivered by cesarean section had significantly higher TBARS levels (p = 0.043). Its concentration > 180.3 μmol/l increases the risk of cesarean section almost by 12 times (p = 0.003).Conclusion. The hormonal aspect of the pathogenesis of prolonged second stage of labor is characterized by higher concentrations of steroid hormones — estradiol and progesterone, as well as by a lower level of relaxin in plasma. The biochemical aspect of the pathogenesis is represented by an increased concentration of lipid peroxidation products, which can be identified with severe physical fatigue in childbirth. The detected changes can be applied in the complex diagnostics of prolonged second stage of labor.

Учреждение образования «Гомельский государственный медицинский университет» г. Гомель, Республика БеларусьЦель: изучить предикторы затянувшегося второго периода родов. Материалы и методы. Проведено исследование родов, осложненных затянувшимся вторым периодом (n = 120). Анализ полученных данных проводился в сравнении с группой контроля, в которую вошли первородящие женщины с физиологическими родами (n = 30).Результаты. Роды, осложненные затянувшимся вторым периодом, значимо чаще начинались с индукции (р = 0,001), значительно чаще была потребность в окситоцине в родах (58 % против 36,6 % в группе контроля; р = 0,034), длительность первого периода была больше (435 (295; 520) мин против 305 (255; 470) мин; р = 0,035), а также отмечена более высокая частота заднего вида затылочного предлежания (14,8 % против 3,3 % в группе контроля; р < 0,001)).Заключение. Применение родоиндукции, необходимость использования окситоцина, а также задний вид затылочного предлежания являются предикторами затянувшегося второго периода родов.Ключевые слова: затянувшийся второй период родов, вакуум-экстракция, кесарево сечение, задний вид затылочного предлежания.Objective: to study the predictors of prolonged second stage of labor. Material and methods. The study of labors complicated by prolonged second stage has been performed (n = 120). The analysis of the obtained data was carried out in comparison with those of the control group which included primiparas with physiological delivery (n = 30).Results. The labors complicated by prolonged second stage more often started with induction (p = 0.001), more often there was a necessity for oxytocin in delivery (58 % vs 36.6 % in the control group; p = 0.034), the duration of the first stage was longer (435 (295; 520) min vs 305 (255; 470) min; p = 0.035), as well as a higher frequency rate of occiput posterior presentation was noted (14.8% versus 3.3% in the control group; p < 0.001)).Conclusion. The application of labor induction, the necessity for the use of oxytocin, as well as occipital posterior presentation are the predictors for prolonged second period of labor.

Objective: to assess the value of the psychoemotional state of pregnant women in the development of a prolonged second period of labor.Material and methods. 76 pregnant women were examined. In 26 women, childbirth was complicated by a prolonged second period of labor, and they constituted the main group. The control group included 50 women who had physiologic birth. The psychoemotional state was analyzed using the Spielberg test and the test of a pregnant woman's attitudes.Results. There were some differences between the groups in terms of the tendency in the levels of personal anxiety and occurrence of high situational anxiety. The Spielberg test has revealed more «positive» affirmative answers than «negative» ones. 46.1 % women in the main group do not «feel a sense of inner satisfaction», which is statistically significantly higher than in the control group - 24.0 % (p = 0.04). In the main group, in contrast to the control group, the women are more often not «worried about possible failures». During the study of the types of the psychological component of the gestational dominant, mixed types were mainly observed, and the distribution in the groups did not have statistically significant differences. The women with a prolonged second period of labor had a tendency to form the predominantly euphoric type of the psychological component of the gestational dominant.Conclusion. During pregnancy, the patients with a prolonged second period formed a coping strategy in the form of a predominantly euphoric attitude to pregnancy associated with elevated situational anxiety.