COURSE OF POSTNATAL PERIOD IN WOMEN WITH HYPOGALACTIA USING PHYTOMEDICATIONS

Abstract

Introduction. Hypogalactia is a condition of decreased secretory activity of mammary glands in lactational period [1, c. 67; 5, c. 98]. Primary and secondary hypogalactias are distinguished. Primary one is conditioned by anatomical and functional pe¬culiarities of mammary glands as well as by moth¬er’s severe diseases associated with extragenital pathology (diabetes mellitus, diffuse toxic goiter), occurs rarely, only in 4-10% of women. Later on, women-in- childbirth who took these preparations had no lactation at first hours or days after labor or lactation appeared in later periods and was insuffi¬cient [3, c. 56; 6, c. 87]. Secondary hypogalactia is mostly a temporary condition [2, c. 35; 8, c. 23]. The reason that caused hypogalactia should be found out to this aim [4, c. 45; 7, c. 56]. A special group of women can be distinguished according to the development of primary hypoga-lactia - these are the women who underwent Cesar-ean section. Early hypogalactia is singled out as to the time of its occurrence. It appears during first 10 days after labor. Late hypogalactia occurs 10 days after. The aim of this work was to study special fea-tures of clinical course of postnatal period and in-vestigate the effect of «Shirafza» phytomedication on lactation in women in childbirth with a decreased lactational function. Material and methods of the study. 60 women in childbirth have been examined who were divided into two groups: I main group - 30 women with a decreased lactational function. II - control group - 30 women in childbirth with a preserved lactation¬al function. Life history, somatic and gynecologic diseases in the history, special features of menstrual and reproductive functions, the course of pregnancy, labor and postnatal period have been studied in all women. In newborns there were determined: condi¬tion at birth, evaluation by Apgar’s scale, primary loss of body-weight and the degree of its recovery by the fourth-fifth day of life, peculiarities of the course in early postnatal adaptational period. Lactational function in women was evaluated on the fourth-fifth day of postnatal period on the basis of clinical examinations of the woman in childbirth, day amount of milk that is produced, food supple¬ments of mixtures to the infant’s feeding and in- deces of weight loss and its restoration during first four-five days after birth. Normal lactation was re¬garded a condition without food supplements, when maximum weight loss was no more than 6%, resto¬ration of initial weight no less than 95% during early neonatal period. S.N. Gaidukov’s classification has been used to evaluate the degree of insufficiency of lactational function (1999): I degree of failure was regarded milk deficiency no more than 25% from the needed quantity; II degree - 50%, III degree - up to 75%, IV degree - over 75%. Statistical processing of the data was performed on a personal computer IBM by means of statistical programme EXCEL making use of variational statistical methods. Authenticity of special features was established by means of Stu-dent’s t-criteria. Differences of indeces were regard-ed authentic at value of p<0,05. Results of the study and discussion. At the age examination it was determined that the majority of women in childbirth were from 19 till 30: in the main group - 25 (83,3%), in the control - 21 (70%) (p>0,05). Average age of women in labor didn’t differ for a fact (25,8±4,2 and 25,1±4,1 of a year correspondingly), A high frequency of somatic pa-thology has been found out: in the main group - in 22 (73,3%), in the control - in 12 (40%) of women (p<0,05). Gynecological diseases in the anamnesis are regarded a factor of risk for disorders in the re-productive system which causes hormonal distur-bances, failure of childbearing function with further complications of postnatal period and also affects formation and duration of lactation. There were gy-necological diseases in the anamnesis in 23 (76,6%) women in the main group and 11 (36,6%) (p<0,05) - in the control. At the same time menstrual function disorders were really more often in the main group - 21 (70%) womem in comparison with the control group - in 4 (13,3%) (p<0,05). In the main group in the structure of menstrual function disorders at-tention was drawn to the predominance of such nosologic forms as dysmenorrheal - in 5 (16,6%), polymenorrhea - in 2 (6,6%), irregular menses - in 12 (40%) women. Only in the main group in the an-amnesis there were revealed such disorders as late menarche - in 1 (3,3%) (p<0,05), hypomenstrual syndrome - in 1 (3,3%) patient. A normal course of postnatal period in the main group was observed in 4 women (13,3%) in the control - in 16 (53,3%). Decrease of lactational function - in 22 (73,3%) women of the main group and 4 (13,3%) in the control one, subinvolution of uterus - in 4 (13,3%) women of the main group and 1 (3,3%) woman of the control group. As subinvolution of uterus oc-curred more often in women from the main group, the factors which contributed to the appearance of this complication were analysed. In women from the main group cardiovascular diseases were regis-tered more often - in 8 (26,6%) and in the control group - 4 (13,3%). In women with a reduced lac-tational function there is a high frequency of dis-orders in menstrual cycle and salpingo-oophoritis in the anamnesis: in the main group - in 21 (70%) and 19 (63,3%); in the control group - in 4 (13,3%) and 5 (16,6%) correspondingly (p<0,05). Incompe¬tent pregnancy in the anamnesis as a factor causing hypogalactia was registered in 53,3% women from the main group. In the majority of women in labor from the main group having hypogalactia there was a thread of abortion - 14 (46,6%), gestosis - in 10 (33,3%), anemia - in 27 (40%); placental insuffi-ciency in 12 (40%), in the control group - in 16,6; 3,3;53,3 and 6,6% cases correspondingly. The most serious intranatal factors for disorders of lactational function after labor were anomalies of labor activity and blood loss over 500 ml that were registered in both groups with almost similar fre¬quency. Both in the main and control groups there weren’t found out any authentic significant perinatal factors among full-term neonates that wound influ¬ence the formation of lactation in postnatal period. The formation of lactation during first 5 days after labor is influenced by the woman’s somatic health condition, her obstetrical-gynecologist status, ob¬stetrical complications which were registered more frequently in women from the main group that’s why we have suggested recovery of lactation¬al function in this group of patients by means of «Shirafza» phytomedication, that is a natural meth-od of high quality based on vegetable raw material which due to complex effect on the woman’s organ¬ism stimulates all stages of lactation, prevents prob¬lems of overweight in feedings mothers and rise of glucose level in blood. Shirafza effect is conditioned by herbs in its composition. Fennel (Foeniculum Mill) contains the mixture of trans-anethol with fenhon, estragol and other components. Structural resemblance of anethol and catecholamine can sup¬port estrogenic activity. Dopamin has a stimulating effect on lactation, in this way anethol can cause milk production re-sponding to dopamine on the determined sections of receptors. Due to this the effect of dopamine de-creases in stimulating milk production. Biologically active substances in Fennel composition stimulate lactogenous action in feeding mothers and also re-move evidences of meteorism, improve digestion release spasms and mobility of the intestine. Caraway provides the increase of milk amount and its nutritional qualities. Trigonella manyco- loured improves bloodflow in the mammary gland, stimulates lactatation and provides the increase of nutritional value of breast milk. Common dill (anethum graveolens) has a seda-tive and soothing action, so women in childbirth are less anxious and its anti-inflammatory action dimin¬ishes the risk of mastitis occurrence. Alcaloids of common dill only increase the amount and quality of breast milk, but in interaction with other compo¬nents of «Shirafza» pass over together with moth¬er’s milk to the infant and prevent meteorism in this way and release abdominal pain (colics) in a breast¬fed infant. The preparation was taken by women from the main group because they complainted mostly of insufficient milk production. The preparation was-taken from the 4-th day of postnatal period by 1 capsule three times a day. 25 women-in labor (83,3%)were marked down to increase the volume of milk on the 5-6th day of the in¬takes as well as to improve milk quality which manifest¬ed inself in the absence of dry «swaddling clothes» syn¬drome, the baby was actively sucking mother’s breast, the woman in childbirth felt the rush of milk, the infant didn’t cry of began to gain weight actively. Conclusions. Women in childbirth show a high frequency of complications in postnatal period (73,3%), that is significantly higher than the analogous index in the control group (40%) Usage of «Shirafza» preparation contributes to the improvement of lactational function in wom¬en in childbirth already on the 5-th day of postnatal period.