Prolonged Labour
Traditionally labour is prolonged if it exceeds 24 hours. When labour is
activity managed, It is termed prolonged if delivery is not imminent after 12
hrs of established labour.
NB. The sun should not set twice in
woman in labour
The latent phase considered prolonged over 20hrs in primigravidae or
over 14 hrs in multigravidae.
Primary dysfunctional-labour progress in active phase of labour is slow
and the cervix dilate less than 1 cm on hour.
Secondary arrest:- After normal progress in early labour, cervical
dilation is arrested in active phase.
·
In-efficient uterine contraction (Power) is the most common cause of
prolonged labour. The cervix dilates slowly or not at all.
·
Pelvic abnormalities (Passage). A contracted pelvis and pelvic tumors
prevent normal progress in labour.
·
The fetus (Passenger):- a large fetus malpostion of the occiput of
malpresntation inhibit the progress of labour.
·
Psychological cause:- Abnormally tense or apprehensive women tend to
have prolonged labors. The primigravidae more often affected than multigravidae
When progress in labour is slow the cause must be identified week
uterine action man be rectified with a syntocinon infusion Caesarian section if nor progress despite
good uterine contraction Obvious disproportion or malpresentation of the fetus
indicate the need for operative deliveries.
Maternal condition: She may be exhausted, dehydrated
andketotic and may be suffering severe pain
·
Encourage and reassure the mother
·
Help to adopt a comfortable position
·
Adequate analgesia should be affered because it will enable her to rest.
·
Administer IV infusion
·
Empty bladder regularly
·
Test urine for ketoses
·
Record intake and out put
·
Allow sips of water
·
If membrane ruptured 24 hours before high vaginal swab is taken for
culture and sensitivity and antibiotic is started
·
Monitor the fetal heart beat
·
Observe amniotic fluid (meconium)
·
Avoid aspiration at delivery
The exception in this phase should be continuous descent and advance of
the fetal head.
·
Hypnotic uterine contractions
Manegement – syntocinon infusion is commenced in order to stimulate
adequate contraction
·
Ineffective maternal effort.
Fear, exhaustion or lack of sensation may inhabit woman’s ability to
push and cause delay, especially in primigravida.
·
A rigid perineum.
A forceps delivery is performed under local anesthesia.
·
Reduced pelvic out let.
A forceps delivery is performed if possible or, in severs cases,
Caesarian section.
·
Large fetus
An operative delivery will be necessary.
·
edema
·
Laceration
·
Uterine prolapsed, PPH
·
Cystocele or rectocele- over stretching of pelvic floor muscles
·
Retention of urine
·
Urinary tract infection during peripureum.
·
Difficult instrumental deliveries
·
Hypoxia
·
Intracranial hemorrhage
Related Topics
Privacy Policy, Terms and Conditions, DMCA Policy and Compliant
Copyright © 2018-2024 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.