KNOWING WHEN OBSTRUCTED LABOUR HAVE OCCURRED

OBSTRUCTED LABOUR

Whenever labour is moving the way it should be,the health workers are happy.But when the labour is undergoing any difficulty it instills fear to the mother and is distressing to both the mother and health workers.

Labour is obstructed when there is no advance of the presenting part despite strong uterine contractions.The obstruction usually occurs at the pelvic brim but may occur at the outlet for example deep transverse arrest in an android pelvis.

CAUSES OF OBSTRUCTED LABOUR
  • Cephalopelvic disproportion
  • Deep transverse arrest
  • Malpresentation
  • pelvic mass
  • Fetal abnormalities such as hydrocephalus
SIGNS OF OBSTRUCTED LABOUR

The presenting part does not enter the pelvic brim despite good contraction.
As the presenting part is unable to descend,cervical dilataton is affected and dilatation is slow.The cervix is describing as loosely like an empty sleeve as the presenting part is not applied to it.The uterine contraction exert pressure on the membranes that are over the cervix,which may result in early rupture or the formation of a large enlongated sac of forewater.

LATE SIGNS OF OBSTRUCTED LABOUR

These arise in a badly managed or neglected labour and the diagnosis of obstructed labour should be made before these signs are seen.
  1. The mother is dehydrated,ketotic,and in constant pain
  2. Clinical signs are pyrexia,tachycardia.
  3. urinary output is poor and haematuria may be present
  4. A visible retraction ring or bandl,s ring is similar in appearance to a full bladder.
  5. On examination the vagina feels hot and dry.
                

                MANAGEMENT
  • Management includes prevention of obstructed labour in the first instance.Appropriate referral can be made prior to the onset of labour and management of the case adjusted to ensure safe delivery.An elective caesarean section may be advocated.
  • An intravenous infusion must be commenced,if not already in progress,to correct dehydration.
  • Blood is taken to cross matching in case a transfusion needed.
  • The mother needs antibiotics to overcome any infection that may be present
COMPLICATION OF OBSTRUCTED LABOUR
  • Vesicovaginal fistula can result due to a trauma to the bladder
  • Intrauterine asphyxia may result in a fresh stillbirth
  • Post-traumatic stress can occur as a result of memories flashback and an increase level of anxiety.
  • increase mortality
So mothers are encourage to attend early and holistic focused antenatal care for a safer delivery to prevent complications that may arise during intra -partum  and postpartum periods.

Comments

Popular posts from this blog

PTYALISM IN PREGNANCY