CURRENT STATE OF THE PROBLEM OF SOFT TISSUES RUPTURE DURING VAGINAL BIRTH IN WOMEN WITH DIABETES AND GESTATIONAL MELLITUS

Аннотация

The review article provides detailed information on the problem of soft tissue ruptures during vaginal delivery in women with diabetes and gestational mellitus. The epidemiological data of various authors on the incidence of gestational diabetes mellitus, which have been studied in many countries, are presented. And the main part of the article describes the etiological features of soft tissue ruptures during vaginal delivery in pregnant women with diabetes and gestational mellitus, complication and prevention of postpartum sepsis. KEYWORDS Gestational diabetes, diabetes mellitus, perineal rupture, fetal macrosomia, sepsis. INTRODUCTION a result of which various degrees of damage to the tissues of the vagina, perineum and cervix may The process of childbirth is accompanied by a appear, which is physiological and represent significant stretching of the birth canal of a woman, as abrasions, cracks and microtraumas with an Volume 02 Issue 04-2022 7 International Journal of Medical Sciences And Clinical Research (ISSN – 2771-2265) VOLUME 02 ISSUE 04 Pages: 07-15 SJIF IMPACT FACTOR (2022: 5. 705) OCLC – 1121105677 METADATA IF – 5.654 Publisher: Oscar Publishing Services Servi asymptomatic course, and rapid self-regeneration in Diabetes mellitus (DM) is a pathology of the the first 24 hours after childbirth. However, in cases endocrine system, in which hyperglycemia is observed of tissue overstretching or due to surgical at a chronic level, arising from a violation of the intervention, ruptures of the cervix, vaginal walls, production and pathway of insulin action. DM that perineum can occur, up to injuries that threaten the occurs during pregnancy is defined as gestational life of a woman and lead to her disability, in particular diabetes mellitus (GDM) [Bondar I.A., 2014; Dedov I.I., uterine rupture [Sacks DA 2012; Riethmuller D 2018]. 2013; McIntyre HD 2018]. According to the International Diabetes Federation, in There are differing data on the etiology of GDM, for 2021 the number of patients with diabetes in the example, some sources report that GDM is a transient world has reached 537 million people. disorder of glucose utilization that develops during pregnancy [Ailamazyan E.K., 2014; Bashmakova N.V., An increase in the number of pregnant women with 2012; Goncharova E.V., 2015; Dhulkotia J.S., 2010], as DM and GDM, a high incidence of complications of well as according to another source, previously pregnancy, childbirth, and an increase in the number undiagnosed and identified during pregnancy, type 1 of pathologies in newborns with GDM of more than or 2 diabetes can be the cause of GDM. 80% caused the scientific and practical interest of obstetrician-gynecologists in gestational diabetes From 2 to 5% of pregnant women are with diabetes mellitus (GDM) [Ushakova O.V. 2014; Shakhnazaryan mellitus and 87.5% of them suffer from GDM, type 1 A.A. 2013; McIntyre HD. 2016; Metzger B.E. 2010]. diabetes - 7.5%, type 2 diabetes - 5%, but current data indicate an increase in patients with type 2 diabetes [ Given the risks of DM, maternal and fetal outcomes at Ruyatkina L.A., 2015; Sievenpiper JL., 2012]. birth may be affected by complications of DM. These include: violations of the contractile activity of the Modern women choose to give birth at a more uterus, due to diabetes - in 20% of the studied, and mature age, which results in an increase in the anomalies in labor activity, observed in 7-20% of cases number of women with pathologies of the endocrine [Anim-Somuah M. 2011]. system, the probability of a pregnant woman 35+ of developing GDM is 8 times higher than in a woman Prevalence, etiology, and risk factors for soft tissue under 25 [Petrov A.V., 2014; Saprina T.V., 2012; tears during vaginal delivery in women with diabetes Laughon SK., 2012; Sugiyama T., 2011]. Therefore, it and gestational diabetes must be taken into account that with GDM, risks are Every year in the world, according to the World Health possible for both the mother and the fetus [Arzhanova O.N., 2011; Deryabina E.G., 2013; Organization, more than 350 thousand women die as Zukhurova N.K., 2010; Logutova L.S., 2013; Mikhalev a result of complications that occurred during E.V., 2015]. pregnancy and in the postpartum period. The indicator of the result of the act of pregnancy for the Complications from the woman: mother and child is determined by the timing, course and complications of pregnancy [Soimenova O.I. 2014]. Volume 02 Issue 04-2022 8 International Journal of Medical Sciences And Clinical Research (ISSN – 2771-2265) VOLUME 02 ISSUE 04 Pages: 07-15 SJIF IMPACT FACTOR (2022: 5. 705) OCLC – 1121105677 METADATA IF – 5.654 Publisher: Oscar Publishing Services Servi 1) complications resulting from diabetes - diabetic The risk group for DM includes: - family predisposition; ketoacidosis, retinopathy, nephropathy, - malformations of the fetus; - polyhydramnios; - hypoglycemia; glycosuria; - perinatal fetal death; - late toxicosis. The clinical sym