Abnormal labour ppt Flashcards
what is normal labour?
Spontaneous onset of contractions at term with a normally grown fetus in cephalic presentation progressing to full dilatation with a spontaneous vaginal delivery of a live infant
Stages of labour?
Latent phase of labour: –effacement + 0-3cm dilation Active phase of labour: –3-10cm dilation –0.5 -1.0 cm / hr (primip vs multip) Transition 2nd stage of labour: –full dilation (10cm) to delivery 3rd stage of labour: –delivery of placenta
Some abnormalities in labour?
Prolonged rupture of membranes
Prolonged pregnancy with induction of labour
Intra-uterine growth restriction / macrosomia
Abnormal presentation
Failure to progress
Operative vaginal delivery
Retained Placenta
What is prelabour/prolonged ROM?
Spontaneous ROM at term without the onset of spontaneous contractions
happens in up to 19% of pregnancies, and 86% of women go into spontaneous labour within 24 hours
What are risks of PROM?
maternal/neonate infection
prolapsed cord
What are risks of prolonged pregnancy?
stillbirth
meconium aspiration
What are methods of IOL?
prostaglandins to ripen cervix and prime uterus for contractions
artificial rupture of membrances
syntocinon infusion
How can abnormal presentation be managed?
External cephalic version
elective CS
Failure to progress in labour is assessed by?
Abdo palpation for engagement of fetal head (5/5 to 0/5)
Vaginal exam for descent of fetal head (Station is -3 to +3) and fetal position (OA, OP)