Abnormal labour Flashcards
What is abnormal labour?
delay in cervical dilation and/or descent of presenting part (<2cm over 4hrs)
led by abnormality in 3 P’s
e.g. fetal malpresentation, multiple pregnancy, uterine scar, induction of labour
What is secondary arrest?
failure to dilate following diagnosis of active labour
What is precipitate labour?
all labour < 4hrs
What are causes of abnormal labour?
Malposition (OP, Brow etc)
Malpresentation (breech)
Narrow pelvis
Macrosomic baby
Early epidural
Abnormal uterine contractions
Cephalo-pelvic disproportion - large head/small pelvis
What are maternal complications of prolonged labour?
Exhausted mother
Dehydration
Infection, sepsis
PPH
Obstructed labour
What are fetal complications of prolonged labour?
Hypooxia, cerebral palsy
Intracranial haemorrhage
Intrapartum death
What is obstructed labour?
labour with no advancement of the presenting part of the fetus despite strong uterine contractions, left untreated may be detrimental
What are complications of obstructed labour?
Postpartum haemorrhage
Sepsis
Ruptured uterus (more likely in 2nd time mum)
Necrotic vesico-vaginal fistula/laceration
DVT
Traumatic delivery
Maternal death
Fetal distress, IUD
What are abnormalities of the 3rd stage of labour? How are they recognised?
Retained placenta
- Signs of placental separation
- Morbidly adherent placenta
Postpartum haemorrhage
- Early risk assessment
- Early recognition of the problem
- Management according to cause
What is DR M C BRAVADO? What is it used for?
Used for cardiotocography
DR - Define Risk
M - Maternal pulse
C - Contractions
BR - Baseline fetal heart rate (110-160bpm)
A - Accelerations (Present vs not present)
Va - Variability (5-25bpm)
D - Decelerations
O - Overall impression (Normal, suspicious, pathological)
