Prolonged labour
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This document defines labor and its stages, signs of prolonged labor, causes of prolonged labor in the first and second stages, effects of prolonged labor on mother and baby, prevention and management of prolonged labor. Labor is defined as a series of events leading to the expulsion of the fetus from the uterus through the vagina. Prolonged labor is diagnosed when the first stage lasts over 12 hours or cervical dilation is less than 1cm/hr for primiparous women or 1.5cm/hr for multiparous women. Causes include problems with uterine contractions, the pelvis, or the fetus. Prevention focuses on early detection and intervention if needed. Management evaluates for causes and effects then treats any issues while carefully
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Obstructed labor
Obstructed labor occurs when the fetus is unable to descend through the birth canal due to an obstruction, despite strong uterine contractions. It remains an important cause of maternal and newborn mortality and morbidity in developing countries. Risk factors include cephalopelvic disproportion, abnormal fetal position or size, or issues with the mother's pelvis. Management involves early detection using a partograph, and definitive relief of obstruction through procedures like vacuum extraction or caesarean section to deliver the baby safely. Complications for both mother and baby can be severe without timely intervention.
Prolonged labour...
This presentation discusses prolonged labor, which occurs when labor lasts over 20 hours for first-time mothers or 14 hours for women who have given birth before. Prolonged labor can happen in the latent or active phases of the first stage, or the second stage. Causes include problems with uterine contractions, the birth canal, or the baby. Prolonged labor can endanger the baby through hypoxia or infection and endanger the mother through hemorrhage, trauma, or infection. Management involves identifying the cause, monitoring for effects, and treating any issues through techniques like amniotomy, oxytocin infusion, pain relief, or cesarean delivery if needed to deliver the baby safely.
Cpd and contracted pelvis
1) Cephalo-pelvic disproportion (CPD) occurs when the fetal head is too large to fit through the mother's pelvis, while a contracted pelvis has diameters smaller than normal.
2) Causes of contracted pelvis include nutritional deficiencies, injuries, diseases, and developmental defects. Contracted pelvises are classified based on architecture (e.g. flat) and degree of contraction.
3) Diagnosis involves history, examination, and pelvimetry. Management depends on degree of disproportion, and may include induction, trial of labor, or cesarean section. Complications can arise from prolonged labor. Close monitoring is needed during labor for those with CPD or contracted pel
Prolonged labour -gihs
The document defines prolonged labour as when the first and second stages of labour last more than 18 hours total. It then discusses the phases of labour and outlines causes of prolonged labour including issues with uterine contractions, the cervix, pelvis, or baby. Diagnosis involves assessing cervical dilation and descent rates. Dangers to the mother and baby include hypoxia, infection, and trauma. Treatments include preventing issues with early monitoring, changing positions, hydration, and pain relief or interventions like amniotomy, oxytocin, or c-section depending on the stage and severity.
Cardiotocography
Cardiotocography (CTG) is a technical method for recording the fetal heartbeat and uterine contractions during pregnancy using ultrasound and tocodynamometry. CTG involves using an electronic fetal monitor, commonly known as a cardiotocograph, to obtain a record of the fetal heart rate and uterine contractions. It was invented in the 1960s and refined to be more accurate. CTG is typically used in late pregnancy or labor to evaluate fetal well-being and identify any signs of hypoxia.
Causes and onset of labour
Labour is initiated by various biochemical and physiological changes that occur in late pregnancy. These include increased production of uterotonins like oxytocin, prostaglandins, and CRH by the fetus and placenta. There is also a withdrawal of progesterone's inhibitory effects and an increase in oxytocin receptors in the uterus. Together, these changes make the uterus more sensitive and responsive to contractions. The cervix simultaneously undergoes ripening, becoming softer, shorter, and more dilated in preparation for labour and delivery.
Shoulder dystocia
“Difficulty encountered in the delivery of the fetal shoulders after delivery of the head.”
Shoulder dystocia is an unpredictable obstetric complication with the incidence of 0.15% to 2%.
An increase in the incidence of shoulder dystocia has been recorded over the last 20 years. Incidence appears to be increasing as birth weights increase.
Placenta previa
Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. Risk factors include multiparity, increased maternal age, smoking, and history of uterine scarring. Symptoms include painless vaginal bleeding unrelated to activity. Management depends on gestational age and stability of the mother and fetus, ranging from bed rest to cesarean delivery. Nursing care focuses on monitoring for signs of decreased cardiac output or tissue perfusion due to blood loss, and providing education and support to address the mother's fears.
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Obstructed labor
Obstructed labor occurs when the fetus is unable to descend through the birth canal due to an obstruction, despite strong uterine contractions. It remains an important cause of maternal and newborn mortality and morbidity in developing countries. Risk factors include cephalopelvic disproportion, abnormal fetal position or size, or issues with the mother's pelvis. Management involves early detection using a partograph, and definitive relief of obstruction through procedures like vacuum extraction or caesarean section to deliver the baby safely. Complications for both mother and baby can be severe without timely intervention.
Prolonged labour...
This presentation discusses prolonged labor, which occurs when labor lasts over 20 hours for first-time mothers or 14 hours for women who have given birth before. Prolonged labor can happen in the latent or active phases of the first stage, or the second stage. Causes include problems with uterine contractions, the birth canal, or the baby. Prolonged labor can endanger the baby through hypoxia or infection and endanger the mother through hemorrhage, trauma, or infection. Management involves identifying the cause, monitoring for effects, and treating any issues through techniques like amniotomy, oxytocin infusion, pain relief, or cesarean delivery if needed to deliver the baby safely.
Cpd and contracted pelvis
1) Cephalo-pelvic disproportion (CPD) occurs when the fetal head is too large to fit through the mother's pelvis, while a contracted pelvis has diameters smaller than normal.
2) Causes of contracted pelvis include nutritional deficiencies, injuries, diseases, and developmental defects. Contracted pelvises are classified based on architecture (e.g. flat) and degree of contraction.
3) Diagnosis involves history, examination, and pelvimetry. Management depends on degree of disproportion, and may include induction, trial of labor, or cesarean section. Complications can arise from prolonged labor. Close monitoring is needed during labor for those with CPD or contracted pel
Prolonged labour -gihs
The document defines prolonged labour as when the first and second stages of labour last more than 18 hours total. It then discusses the phases of labour and outlines causes of prolonged labour including issues with uterine contractions, the cervix, pelvis, or baby. Diagnosis involves assessing cervical dilation and descent rates. Dangers to the mother and baby include hypoxia, infection, and trauma. Treatments include preventing issues with early monitoring, changing positions, hydration, and pain relief or interventions like amniotomy, oxytocin, or c-section depending on the stage and severity.
Cardiotocography
Cardiotocography (CTG) is a technical method for recording the fetal heartbeat and uterine contractions during pregnancy using ultrasound and tocodynamometry. CTG involves using an electronic fetal monitor, commonly known as a cardiotocograph, to obtain a record of the fetal heart rate and uterine contractions. It was invented in the 1960s and refined to be more accurate. CTG is typically used in late pregnancy or labor to evaluate fetal well-being and identify any signs of hypoxia.
Causes and onset of labour
Labour is initiated by various biochemical and physiological changes that occur in late pregnancy. These include increased production of uterotonins like oxytocin, prostaglandins, and CRH by the fetus and placenta. There is also a withdrawal of progesterone's inhibitory effects and an increase in oxytocin receptors in the uterus. Together, these changes make the uterus more sensitive and responsive to contractions. The cervix simultaneously undergoes ripening, becoming softer, shorter, and more dilated in preparation for labour and delivery.
Shoulder dystocia
“Difficulty encountered in the delivery of the fetal shoulders after delivery of the head.”
Shoulder dystocia is an unpredictable obstetric complication with the incidence of 0.15% to 2%.
An increase in the incidence of shoulder dystocia has been recorded over the last 20 years. Incidence appears to be increasing as birth weights increase.
Placenta previa
Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. Risk factors include multiparity, increased maternal age, smoking, and history of uterine scarring. Symptoms include painless vaginal bleeding unrelated to activity. Management depends on gestational age and stability of the mother and fetus, ranging from bed rest to cesarean delivery. Nursing care focuses on monitoring for signs of decreased cardiac output or tissue perfusion due to blood loss, and providing education and support to address the mother's fears.
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This document discusses pain management during labor and childbirth. It explains that labor pain is unique compared to other types of pain. Sources of labor pain include cervical dilation, uterine contractions, and fetal descent. Factors like preparation, culture, anxiety and fatigue can influence a woman's experience of pain. Non-pharmacological methods for managing pain include breathing, positioning, water therapy and relaxation techniques. Pharmacological options include opioids, epidural anesthesia and spinal anesthesia, each with advantages and disadvantages. Complications of regional anesthesia include hypotension and fetal distress. General anesthesia is riskier for mother and fetus due to issues like failed intubation or aspiration.
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Puerperium complications and minor ailments include after pains caused by uterine contractions to expel blood clots, perineal pain from tears or hematomas, breast engorgement from milk accumulation, cracked nipples from improper feeding technique, and mastitis caused by blocked milk ducts or infection. Nursing care focuses on pain management, perineal examination and treatment, frequent breastfeeding or pumping, and antibiotics for infections. Subinvolution of the uterus can occur if the uterus does not fully shrink postpartum and may require exploring the uterus, antibiotics, or pelvic support.
Destructive operation
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
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The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
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This document provides information about placenta previa, including its definition, causes, risk factors, types, clinical features, complications, diagnosis, management, and prognosis. Placenta previa is when the placenta is implanted partially or completely over the lower uterine segment. It occurs in approximately 1 in 250 births. The exact cause is unknown, but theories include the fertilized ovum implanting low, defects in the decidua, and previous cesarean sections. Management depends on gestational age and bleeding, and may involve expectant treatment, cesarean section, or in some cases vaginal delivery. Maternal and fetal prognoses have improved due to early diagnosis, blood transfusions, antibiotics, and increased
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(1) Abnormal progress of labour can include prolonged labour, obstructed labour, or abnormal uterine contractions. Prolonged labour is defined as poor cervical dilation or delayed fetal descent. Obstructed labour occurs when there is a mechanical obstruction preventing delivery.
(2) Factors that can contribute to abnormal labour include uterine dysfunction, fetal issues like large size or malpositioning, and maternal factors like pelvic abnormalities. Complications of prolonged labour include maternal exhaustion and increased C-section rates, as well as risks to the fetus like distress and infection.
(3) Abnormal labour is monitored using a partogram to track cervical dilation, fetal position and heart rate. Management depends on the specific issue,
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Abnormal labour
This document discusses abnormal labour, defined as failure to meet defined milestones and time limits for normal labour. It can be caused by issues with uterine contractions (power), the birth canal (passages), or the fetus (passenger). Types of abnormal labour include slow progress/protraction disorders, arrest of progress/arrest disorders, and precipitate labour. Management involves assessing for causes, supporting labour through hydration and pain relief, and potentially augmenting contractions, assisting delivery, or performing a caesarean section if needed for fetal wellbeing. Complications of abnormal labour include increased risk of cesarean, fetal distress, and postpartum hemorrhage.
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This document describes the procedure for manual removal of the placenta (MRP). MRP is performed when the placenta fails to deliver within 30 minutes of childbirth. It involves inserting fingers into the uterus to locate and detach the placenta from the uterine wall while supporting the fundus. Once detached, the placenta is withdrawn from the uterus while continuing to provide counter-traction. Oxytocin is administered to encourage uterine contraction and prevent hemorrhage. The placenta is examined for completeness and the uterus is checked for contraction to ensure the procedure was successful. Potential complications include shock, postpartum hemorrhage, puerperal sepsis, and inversion or hysterectomy.
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Caesarean section is the delivery of a fetus through an incision made in the mother's abdomen and uterus. It was originally a fatal operation but is now commonly performed worldwide. The WHO recommends an ideal c-section rate of 15-20% though rates have increased due to factors like previous c-sections and increased fetal distress diagnosis. C-sections are performed under spinal or epidural anesthesia with various abdominal incision types closed afterwards. Complications can include hemorrhage, infection, and injury to internal organs during the operation or issues like ileus, DVT and wound separation after.
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Postpartum hemorrhage is defined as blood loss exceeding 500 mL after vaginal delivery or 1000 mL after cesarean delivery within 24 hours. It occurs in 4% of deliveries and is primarily caused by uterine atony, genital tract trauma, retained placental tissue, and coagulation disorders. Management involves identifying the cause, such as through manual exploration of the uterus, repairing lacerations, administering uterotonic drugs to contract the uterus, and treating underlying coagulation disorders. Surgical interventions like hysterectomy may be needed for severe cases unresponsive to initial treatment measures.
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This topic contains definition, incidence, causes, effect on mother and fetus, clinical features, prevention, management of Obstructed labour.
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Prolonged and obstructed labor
The document discusses prolonged and obstructed labor. Prolonged labor is defined as the first and second stages of labor taking more than 18 hours total. Obstructed labor occurs when descent is arrested due to a mechanical obstruction, despite adequate contractions. Causes include cephalopelvic disproportion, malpositions, or large babies. Risks include maternal exhaustion, infection, and fetal distress or death. Treatment involves identifying the obstruction's cause, resuscitating the mother, relieving the obstruction via vaginal operative delivery or C-section, and preventing or treating complications like infection.
Prolonged and obstructed labour
This document describes prolonged and obstructed labor. It defines prolonged labor as when the first and second stages of labor last more than 18 hours total. Obstructed labor occurs when there is poor or no progress despite strong contractions, usually due to issues with the fetus (fault in passenger) or birth canal (fault in passage). Causes include cephalopelvic disproportion, malpositions, big baby, or contracted pelvis. Diagnosis involves assessing cervical dilation rate and fetal descent rate with a partograph. Treatment depends on the stage of labor affected and may include oxytocics, analgesics, assisted delivery, or C-section. Complications can be serious for both mother and baby if not resolved.
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This document discusses pain management during labor and childbirth. It explains that labor pain is unique compared to other types of pain. Sources of labor pain include cervical dilation, uterine contractions, and fetal descent. Factors like preparation, culture, anxiety and fatigue can influence a woman's experience of pain. Non-pharmacological methods for managing pain include breathing, positioning, water therapy and relaxation techniques. Pharmacological options include opioids, epidural anesthesia and spinal anesthesia, each with advantages and disadvantages. Complications of regional anesthesia include hypotension and fetal distress. General anesthesia is riskier for mother and fetus due to issues like failed intubation or aspiration.
Complication of puerperium
Puerperium complications and minor ailments include after pains caused by uterine contractions to expel blood clots, perineal pain from tears or hematomas, breast engorgement from milk accumulation, cracked nipples from improper feeding technique, and mastitis caused by blocked milk ducts or infection. Nursing care focuses on pain management, perineal examination and treatment, frequent breastfeeding or pumping, and antibiotics for infections. Subinvolution of the uterus can occur if the uterus does not fully shrink postpartum and may require exploring the uterus, antibiotics, or pelvic support.
Destructive operation
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Prolonged labour
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Cervical incompetence
This document discusses cervical incompetence, also known as cervical insufficiency. It defines cervical incompetence as the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor during the second trimester. The document outlines the causes, diagnosis, and management of cervical incompetence, with a focus on cervical cerclage procedures like the McDonald and Shirodkar techniques. Cervical cerclage involves surgically placing a suture around the cervix to reinforce it and prevent painless dilation during pregnancy.
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This document provides information about placenta previa, including its definition, causes, risk factors, types, clinical features, complications, diagnosis, management, and prognosis. Placenta previa is when the placenta is implanted partially or completely over the lower uterine segment. It occurs in approximately 1 in 250 births. The exact cause is unknown, but theories include the fertilized ovum implanting low, defects in the decidua, and previous cesarean sections. Management depends on gestational age and bleeding, and may involve expectant treatment, cesarean section, or in some cases vaginal delivery. Maternal and fetal prognoses have improved due to early diagnosis, blood transfusions, antibiotics, and increased
Abnormal progress of labor for 4th year med.students
(1) Abnormal progress of labour can include prolonged labour, obstructed labour, or abnormal uterine contractions. Prolonged labour is defined as poor cervical dilation or delayed fetal descent. Obstructed labour occurs when there is a mechanical obstruction preventing delivery.
(2) Factors that can contribute to abnormal labour include uterine dysfunction, fetal issues like large size or malpositioning, and maternal factors like pelvic abnormalities. Complications of prolonged labour include maternal exhaustion and increased C-section rates, as well as risks to the fetus like distress and infection.
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Abnormal labour
This document discusses abnormal labour, defined as failure to meet defined milestones and time limits for normal labour. It can be caused by issues with uterine contractions (power), the birth canal (passages), or the fetus (passenger). Types of abnormal labour include slow progress/protraction disorders, arrest of progress/arrest disorders, and precipitate labour. Management involves assessing for causes, supporting labour through hydration and pain relief, and potentially augmenting contractions, assisting delivery, or performing a caesarean section if needed for fetal wellbeing. Complications of abnormal labour include increased risk of cesarean, fetal distress, and postpartum hemorrhage.
Manual removal of placenta
This document describes the procedure for manual removal of the placenta (MRP). MRP is performed when the placenta fails to deliver within 30 minutes of childbirth. It involves inserting fingers into the uterus to locate and detach the placenta from the uterine wall while supporting the fundus. Once detached, the placenta is withdrawn from the uterus while continuing to provide counter-traction. Oxytocin is administered to encourage uterine contraction and prevent hemorrhage. The placenta is examined for completeness and the uterus is checked for contraction to ensure the procedure was successful. Potential complications include shock, postpartum hemorrhage, puerperal sepsis, and inversion or hysterectomy.
Caesarean section
Caesarean section is the delivery of a fetus through an incision made in the mother's abdomen and uterus. It was originally a fatal operation but is now commonly performed worldwide. The WHO recommends an ideal c-section rate of 15-20% though rates have increased due to factors like previous c-sections and increased fetal distress diagnosis. C-sections are performed under spinal or epidural anesthesia with various abdominal incision types closed afterwards. Complications can include hemorrhage, infection, and injury to internal organs during the operation or issues like ileus, DVT and wound separation after.
Breech presentation
This document discusses breech presentation, which occurs when a baby is positioned bottom or feet first in the uterus instead of head first. It defines the different types of breech positions and discusses risk factors, diagnosis, management options, and complications associated with vaginal breech delivery and cesarean section for breech babies. Management options include external cephalic version, vaginal delivery, or cesarean section depending on the specific situation. Risks and procedures for both vaginal delivery and cesarean section are outlined.
11.Postpartum+Hemorrhage
Postpartum hemorrhage is defined as blood loss exceeding 500 mL after vaginal delivery or 1000 mL after cesarean delivery within 24 hours. It occurs in 4% of deliveries and is primarily caused by uterine atony, genital tract trauma, retained placental tissue, and coagulation disorders. Management involves identifying the cause, such as through manual exploration of the uterus, repairing lacerations, administering uterotonic drugs to contract the uterus, and treating underlying coagulation disorders. Surgical interventions like hysterectomy may be needed for severe cases unresponsive to initial treatment measures.
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This topic contains definition, incidence, causes, effect on mother and fetus, clinical features, prevention, management of Obstructed labour.
Preterm LABOUR
Preterm labor is defined as the onset of labor between 20 weeks of gestation and 37 weeks. Risk factors include a previous preterm birth, low socioeconomic status, infections, and short cervical length. Diagnosis involves assessing for contractions and cervical changes. Treatment aims to delay delivery through tocolysis, corticosteroids to aid lung maturation, antibiotics for infections, and magnesium sulfate for neuroprotection. Progesterone supplementation and cerclage placement can help prevent preterm birth in high risk women. The goal is to prolong pregnancy and improve neonatal outcomes.
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This document discusses multiple pregnancies, also known as twin or higher order pregnancies. It defines types of multiple pregnancies including twins, triplets, quadruplets, etc. It describes the two types of twin pregnancies - monozygotic (identical) and dizygotic (fraternal) twins. It discusses the incidence, duration, etiology, lie and presentation, physiological changes in the mother, diagnosis, complications, and nursing management of multiple pregnancies.
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The document discusses prolonged and obstructed labor. Prolonged labor is defined as the first and second stages of labor taking more than 18 hours total. Obstructed labor occurs when descent is arrested due to a mechanical obstruction, despite adequate contractions. Causes include cephalopelvic disproportion, malpositions, or large babies. Risks include maternal exhaustion, infection, and fetal distress or death. Treatment involves identifying the obstruction's cause, resuscitating the mother, relieving the obstruction via vaginal operative delivery or C-section, and preventing or treating complications like infection.
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This document describes prolonged and obstructed labor. It defines prolonged labor as when the first and second stages of labor last more than 18 hours total. Obstructed labor occurs when there is poor or no progress despite strong contractions, usually due to issues with the fetus (fault in passenger) or birth canal (fault in passage). Causes include cephalopelvic disproportion, malpositions, big baby, or contracted pelvis. Diagnosis involves assessing cervical dilation rate and fetal descent rate with a partograph. Treatment depends on the stage of labor affected and may include oxytocics, analgesics, assisted delivery, or C-section. Complications can be serious for both mother and baby if not resolved.
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The first stage of normal labour begins with the onset of true labour pains and ends with full dilatation of the cervix. For primi-gravida women this stage typically takes 12 hours, and for multi-gravida women it takes around 6 hours. Nursing care during this stage includes admission assessment, perineal care, monitoring contractions and vital signs, allowing rest and ambulation as tolerated, and shifting the patient to the delivery table once full dilatation is reached. Evidence shows that practices like ambulation during labour, support from a companion, and restricted vaginal exams and enemas can help make the first stage of labour safer and more comfortable.
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Normal labour involves a series of events that expel the fetus from the uterus through the vagina. It is considered normal when it is spontaneous, occurs at term with a single fetus in vertex presentation, has no undue prolongation, and no maternal or fetal complications. Labour is divided into stages - the first stage involves cervical dilation until full dilation, the second stage is expulsion of the fetus, and the third stage involves delivery of the placenta. Uterine contractions and retraction are the primary forces that cause cervical dilation and expulsion of the fetus, while voluntary abdominal muscle contractions aid in the second stage.
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- Normal ranges for assessments are provided along with signs that indicate need for intervention or potential complications.
L31 Normal Labor & Delivery
Normal labor and delivery involves 3 stages: 1) dilation of the cervix, 2) delivery of the baby, and 3) delivery of the placenta. The fetus moves through the birth canal via engagement, descent, flexion, internal rotation, extension, and external rotation. Labor is considered normal if it is spontaneous in onset, involves a single cephalic fetus at term, lasts less than 12 hours for first-time mothers and 8 hours for others, and results in an unassisted vaginal birth.
UNCOORDINATED UTERINE ACTION in obstetrics and gynecological
I. Prolonged labor is defined as labor lasting longer than 18-24 hours. It can occur when there are issues with uterine contractions (fault in power), the size and shape of the pelvis (fault in passage), or position of the baby (fault in passenger).
II. Precipitate labor is when the first and second stages are less than two hours. It is more common in multiparous women and can be caused by factors like a small baby in a favorable position or strong uterine contractions.
III. Management of prolonged labor involves careful evaluation, correcting dehydration, and definitive treatments like amniotomy, oxytocin infusion, or cesarean section if vaginal delivery is
prolonged labor.pptx obg seminar 4th year
1) Prolonged labor is defined as labor lasting over 20 hours for first time mothers and over 14 hours for mothers who have previously given birth. It can be caused by issues like malpresentation, cephalopelvic disproportion, or problems with uterine contractions.
2) Signs of prolonged labor include exhaustion, dehydration, high pulse rate, and potential fetal distress. It increases risks for both mother and baby.
3) Management of prolonged labor involves identifying the cause, giving the mother fluids and pain relief, monitoring progress and fetal wellbeing, and potentially assisting delivery or performing a C-section if vaginal delivery is not possible or safe.
1.pptx
The document discusses the normal processes involved in labour and delivery, including the female pelvis and fetal skull, the three stages of labour, monitoring labour progression, managing each stage of labour, and the immediate care of the newborn. Key topics covered include cervical dilation, fetal positioning, contractions, vital sign monitoring, pain management, delivery of the baby, placental delivery, and postpartum care of the mother.
Normal labour and its physiology
This presentation contains :-
1.Introduction of normal labour
2. Definiation of normal labour
3.Criteria of normal labour
4. Physiology of normal labour
5. Pathophysiology of labor
6.Estrogen
7. Prostaglandin
8. Oxytocin
9. True labor and false labor difference
10. Uterine contraction in labor
11. Stages of labour
12. Management of 1 st stage
13. management of 2 nd stage
14. mamagement of 3 rd stage of labor
15. Cervix dilation
16. Friedman's curve
17. Fetal skull
18. Diameter of fetal skull
19. Sutures in fetal head
20. Moulding
21. Mechanism of labour
Induction of labour
This document discusses induction of labor (IOL), which is the stimulation of uterine contractions through medical, surgical, or combined methods for the purpose of vaginal delivery after the period of viability. The main purposes of IOL are when the risk to the mother or fetus is greater if the pregnancy continues, such as in cases of hypertension, diabetes, post-maturity, fetal growth issues, or other complications. Effective IOL requires assessing factors like the Bishop score to determine cervical ripeness, fetal lung maturity, position and well-being. Methods of cervical ripening discussed include prostaglandins, oxytocin, mifepristone, membrane stripping, and amniotomy. Oxytocin is used for labor induction once
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UNCOORDINATED UTERINE ACTION in obstetrics and gynecological
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Unconsciousness 150317014129-conversion-gate01
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Prolonged labour
- 1. MISS ASMI ROYCHOWDHURY NURSING TUTOR RAMA COLLEGE OF NURSING
- 2. DEFINITION OF LABOUR:- Series of events that take place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina in to the outer world.
- 3. START OF THE TRUE LABOUR PAIN TO FULL DILATATION OF THE CERVIX (10CM) Latent phase (primi-8hrs,multi- 4hrs) Active phase (primi-4hrs,multi- 2hrs)
- 4. From full dilatation of the cervix to the expulsion of the fetus. oPropulsive phase oExpulsive phase oDuration :-Primi=2hours Multi =30 minutes
- 5. From expulsion of the fetus to the expulsion of the placenta Phase of placental separation Phase of placental descent Phase of placental expulsion DURATION – 15 minutes (primi and multi) 5 minutes in active management.
- 6. Up to 1 hours of delivery of placenta
- 7. Labor is said to be prolonged when the combined duration of the first and second stage is more than the arbitrary time limit of 18 hours. WHO-labor is considered to be prolonged when the cervical dilatation rate is less than1cm/hr and descent of the presenting part is <1 cm/hr for a period of minimum 4 hours observation
- 8. 1. FIRST STAGE a) FAULT IN POWER :- o Abnormal uterine contraction b)FAULT IN PASSAGE:- o Contracted pelvis o Cervical dystocia o Pelvic tumor o Full bladder
- 9. C) FAULT IN THE PASSENGER oMalposition or mal presentation oCongenital anomalies of the fetus (hydrocephalus)
- 10. 2) SECOND STAGE :- a) FAULT IN THE POWER :- o Uterine inertia o Inability to bear down o Epidural analgesia o Constriction ring
- 11. b) FAULT IN THE PASSAGE :- o CPD,android pelvis, contracted pelvis o Undue resistance o Soft tissue pelvic tumor c) FAULT IN THE PASSENGER :- • Malposition • Malpresentation • Big baby • Congenital malformation of the body
- 12. PROLONGED LABOR IS NOT A DIAGNOSIS BUT IT IS THE MANIFESTATION OF AN ABNORMALITY. FIRST STAGE DURATION >12 HOURS CERVICAL DILATATION _<1cm/hr(primi) <1.5 cm/hr (multi) SECOND STAGE :- Duration >2hrs (nullipara),>1hrs (multipara)
- 13. FETAL HYPOXIA INTRAUTERINE INFECTION INTRACRANIAL STRESS INCREASE OPERATIVE DELIVERY MATERNAL DISTRESS POSTPARTUM HEMORRHAGE TRAUMA TO THE GENITAL TRACT PUERPEAL SEPSIS SUBINVOLUTION
- 14. PREVENTION:- ANTENATAL OR EARLY DETECTION USE OF PARTOGRAPH SELECTIVE AND JUDICIOUS AUGMENTATION CHANGE OF POSTURE IN LABOR,AVOIDANCE OF DEHYDRATION IN LABOR EVALUATE CAREFULLY TO FIND OUT • Cause of prolonged labour • Effect on the mother • Effect on the fetus
- 15. CORRECT FLUID AND ELECTROLYTE IMBALANCE CONTROL OF INFECTION (AMPICILLIN,METRONIDAZOLE) EMPTYING THE BLADDER EMPTYING THE STOMACH BLOOD CROSS MATCHING
- 16. VAGINAL EXAMINATION AND CLINICAL PELVIMETRY DONE IF ONLY UTERINE ACTIVITY IS SUBOPTIMAL, AMNIOTOMY/OXYTOCIN INFUSION EFFECTIVE PAIN RELIEF SECONDARY ARREST :- CAREFUL USE TO OXYTOCIN CESAREAN SECTION DELIVERY
- 17. SHORT PERIOD OF EXPECTANT MANAGEMENT IS REASONABLE PROVIDED THE FHR IS REASSUARING AND VAGINAL DELIVERY IS EMMINENT. APPROPRIATE ASSISTED DELIVERY,VAGINAL OR ABDOMINAL SHOULD BE DONE DIFFICULT INSTRUMENTAL DELIVERY SHOULD BE AVOIDED.