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Use of antispasmodics in laboring women with breech presentation of the fetus
Medical expert of the article
Last reviewed: 04.07.2025
In preparation for childbirth and during labor, it is necessary to systematically administer antispasmodics at intervals of 2-3 hours, taking into account the nature of labor, the type of labor anomaly, and the pharmacodynamics of the antispasmodics used.
The use of antispasmodics in women in labor with breech presentation of the fetus leads to a shortening of the duration of labor by an average of 3-4 hours for both first-time and repeat mothers. In case of weak labor activity and lack of biological readiness for labor, the highest antispasmodic effect is provided by the centrally acting N-anticholinergic - spasmolitin in a dose of 100-200 mg (0.1-0.2 g).
In the hypodynamic form of weakness of labor activity against the background of reduced basal (main) tone of the uterus, the highest spasmolytic effect is provided by the use of a solution of halidoros at a dose of 0.05 g intramuscularly or intravenously slowly with a 20% glucose solution - 40 ml. The use of a solution of halidoros has a pronounced spasmolytic effect at various degrees of dilation of the uterine os, even with a preserved cervix in primiparous women.
In case of uncoordinated labor in women in labor with breech presentation of the fetus, the spasmoanalgesic baralgin is administered to regulate uterine contractions and obtain a pronounced central analgesic effect. The latter is used in a dose of 5 ml of a standard solution, preferably intravenously very slowly with 20 ml of a 40% glucose solution.
In primiparous women, the spasmolytic effect of baralgin and normalization of the contractile function of the uterus are manifested with a preserved and mature cervix. In case of a protracted labor due to discoordination of labor forces, it is most appropriate to use it in primiparous women when the cervix is opened by 4 cm or more. In case of excessive labor in women in labor with a breech presentation of the fetus, it is recommended to use combinations of neurotropic agents (2.5% propazine solution - 1 ml) in combination with a 2 ml pipolfen solution and a 1% promedol solution - 2-4 ml or 2% - 1-2 ml (0.02-0.04 g) intramuscularly in one syringe, and if there is no effect, additionally use ether anesthesia by hardware in combination with O 2. A high regulating effect is achieved by using fluorothane inhalations in a concentration of 1.5-2.0 vol.%, with normalization of labor occurring in the first 5 minutes (with an increase in the fluorothane concentration from 2 vol.% and above, labor almost completely stops). At the same time, normalization of the fetal heartbeat is also observed. The duration of fluorothane inhalations should be at least 20-30 minutes, since excessive labor may reoccur. Fluorothane inhalations are performed only by an experienced anesthesiologist using the Trilan device, which has a graduation for fluorothane, or an inhalation anesthesia device.
In recent years, beta-adrenergic agonists have become increasingly widespread in the treatment of excessive labor.