MIDWIFERY CARE IN PHYSIOLOGICAL DELIVERY - SUPERVISION OF PREGNANT WOMAN AND FOETUS

Abstract

Sam porođaj predstavlja fiziološki proces završetka trudnoće i kao takvom trebalo bi omogućiti prirodan tijek i završetak bez previše uplitanja medicinskih intervencija. Međutim, nekada nam stanja rodilje ili ploda ne dopuštaju prirodan tijek već su potrebne medicinsko-tehničke intervencije. Da bi mogli prepoznati nepravilnosti i komplikacije u porođaju potrebno je prvotno poznavati fiziologiju porođaja kako bi reagirali na svako odstupanje od normalnog. Pri tome se služimo raznim metodama nadzora rodilje i ploda u tijeku cijelog porođaja. Kod rodilje se prate njene vitalne funkcije, dilatacija cerviksa i trudovi dok kod fetusa registriramo fetalne otkucaje uz pomoć kardiotokografa (CTG) . CTG podrazumijeva grafički prikaz aktivnosti srca ploda i aktivnosti mišića zida materice tijekom porođaja (18). Iako se CTG koristi rutinski postoji kvalitetnija metoda za nadzor fetalne oksigenacije fetalna pH-metrija, koja se redovno primjenjuje u nekoliko hrvatskih rodilišta.The labor represents the end of physiological process of pregnancy, therefore the natural process and end of pregnancy should be made possible without too much medical interventions. However parturient woman or fetus condition sometimes does not enable natural process, instead medical interventions are needed. If we want to identify irregularities and possible complications in childbirth, it is necessary to know the physiology of birth in order to respond to any deviation from normal. This is why various methods of monitoring parturients and fetus are carried out throughout the process of labor. In a parturient woman vital functions, dilation of the cervix and contractions are monitored, while fetal heartbeat is detected with the help of cardiotocography (CTG). CTG includes graphic display of the fetal heartbeat and uterine contractions during childbirth. Although CTG is used frequently, there are better methods for monitoring fetal oxygenation, such as pH-metry, which is regularly used in several Croatian maternity hospitals