🩺 MedAtlax

Search

SearchSearch

Abnormal Labour β€” Management

Sep 14, 20252 min read

Management of Prolonged Labour

Diagnosis

History should include:

  • Age.
  • parity.
  • Duration of labour.
  • Partograph abnormality.
  • Duration of ROM(amount & colour of liquor).
  • Antenatal records and complications
  • Previous prolonged labour: * fetal death, * instrumental delivery. * caesarean sections.

Examination

  • General exam.

    • Features of maternal distress.

  • Abdominal exam (Revise):

    • Frequency and intensity of uterine contractions.
    • Presentation.
    • Engagement.
    • Estimated fetal weight

Retraction ring (bandl’s ring) is seen and felt between upper & lower segment (site of uterine rupture).

Obstructive Labor

Vaginal Examination

  • Vaginal exam:
    • Dry hot vagina.
    • Cervical dilatation.
    • Fetal presentation and position, station.
    • Excessive caput and moulding.

Treatment of Poor Progress

  • Treatment of poor progress in the 1st stage of labour :

    • Good hydration.
    • Pain relief.
    • Empty bladder.
    • Cross match blood.
    • Emotional support.

  • When poor progress in labour is suspected : Repeat vaginal examination every 2(rather than 4 hours ) & plot on partograph

In the 2nd Stage of Labour

  • Rehydration.
  • Intravenous oxytocin for inefficient uterine cont.
  • Instrumental birth can be considered.
  • Caesarean delivery if :
    • Instrumental birth attempt is unsuccessful.
    • or if obstructed labour present.
  • Episiotomy for a resistant perinium.

Treatment of CPD

  • Oxytocin must never be used in a multiparous woman where CPD is suspected.
  • A Caesarean section is indicated in cases of CPD with elements of obstructed labour

Graph View

Backlinks