Shigambecova N.S.

(Supervisor: Professor. Assistant department of neurology

KispaevaT.T.)

Karaganda state medical university

Optimal childbirth at dorsopathies of lumbosacral part in pregnant.

Actuality: Degenerative-dystrophic lesions of the spine is one of the most common human diseases. They are already beginning to develop in adolescence and reach its "heyday" in the most active working period of human being at age from 35 to 60 years. According Y.Y. Popelyansk more common is osteochondrosis of the lumbar, 38% of compression degenerative disc disease of the lumbar and reflex syndromes is at 18 years old and above and from 31 to 40 years - 48%, more mature age 41-50 is 71%.[3.] Pain syndromes and neurological disorders in the region of the lumbosacral ranked 1st place in prevalence of clinical manifestations of osteochondrosis of the spine not only at people of different age and sex, but also in pregnant women up to 75-80%. Therefore, it is relevant the study of the syndromes and methods of treatment of dorsopathies of lumbosacral in pregnant, as it affects not only the patient, but also on pregnancy and on the subsequent choice of method of delivery.[1, 2, 4].

The aim of our research is to study the impact of herniated discs and degenerative disc disease of the lumbar in the course of pregnancy and method of delivery.

Materials and methods: the study was conducted in Karaganda on the base of Regional Clinical Hospital. For the study were analyzed cases from 2013 to 2016, selected out of 80 pregnant women with dorsopathies of lumbosacral, ranging in age from 22 to 35 years. Pregnant women were divided into two groups according to the age: I group from 22 to 29, II group from 30-35 years. According to the calculations were calculated the 38 hernias of them: from I group - 16 women, II group - 22 females; 42 of degenerative disc disease of the lumbosacral: the I group - 25 women, II group - 17 women .

Groups	Herniated disc	Osteochondrosis of the lumbar
I 22-29	16 (42%)	25 (59%)
II 30-35	22 (58%)	17 (41%)

Results and discussion: According to our research of 80 pregnant women with herniated disc L4-L5 held surgically in 18 patients (47%), I group - 5, II group - 13 women; 20 of them are natural childbirth (53%) , I group - 11, II group - 9 women; also divided hernias with concomitant diseases and without it. With comorbidity natural childbirth in 9 women, surgically 11 women, without comorbidities natural childbirth of 10 women, surgically in 8 women. Pregnant with osteochondrosis of the lumbosacral also were counted of them natural childbirth in 40 women (95%): I group -25, II group -15 women, surgically in 2 women (5%): II group - 2 women. With comorbidities, natural childbirth in 31 women, surgically in 1 woman; without comorbidity, natural childbirth 9 women, surgically in 1 women. The results of this study osteochondrosis of the lumbosacral 95% of the cases resulted in natural deliveries. In the presence of disc herniation L4-L5 relatively according 2 groups, no significant differences were observed. The data indicate that the various extragenital pathology in particular herniated discs L4-L5 in pregnant women can lead to changes of pregnancy and the online method of delivery.

Dorsopathies	Natural childbirth	Surgically
Herniated disc L4-L5	20 women 53%	18 women 47%
Osteochondrosis of the lumbar	40 women 95%	2 women 5%

Dorsopathies	With pathology		Without pathology
Dorsopathies	Natural childbirth	Surgically	Natural childbirth	Surgically
Herniated disc L4-L5	9	11	10	8
Osteochondrosis of the lumbar	31	1	9	1

Conclusions:1. The lack of disc hernias L4-L5 in pregnant 95% of the cases resulted in natural deliveries.

2. Women with hernias of L4-L5 prior to the registration of pregnancy must be regularly observed and treated by a neurologist with the aim of decrease manifestations of hernia.

Literature:

1. Avakian GN, Mendel OI, Nikiforov AS Current approaches to the treatment of complications of osteochondrosis. Eng. honey.Zh. 2010; 26: 1633-1638.

2. Akhmadov TZ Is there a crisis in the vertex tebronevrologii (organizational and of methodological aspects of the study osteohon- Droz spinal problems). neurology and psychiatry Journal of them SS Korsakov in 2012; 1: 116-117.

3. Duschanova GA, GU Tuksanbaeva, Zharkin- Bekova NA New approaches to the diagnosis, treatment Medicine and Ecology, 2012 September 3 Clinical Review Literature medicine NIJ and prevention of vertebral diseases of the peripheral nervous system. Shym- Kent: YUKGMA; 2005: 8-14.

4. Mironov SP Local ozonotera- Pius with lumbosacral pain syndrome / C. P. Mironov, GM Burmakova // Vestn. trauma. orthopedist. - 2007. - №3. - S. 22-27.