ABNORMAL LABOUR

Definitions
Stages and Phases of Normal Labour
Abnormal Patterns of Labour
Classification of Abnormal Labour/Dystocia
Diagnosis and Management of Abnormal Labour

1. TOPIC : ABNORMAL LABOUR Subject: Obstetrics & Gynecology Prepared & Presented By: Rabia Khan Baber

2. ABNORMAL LABOUR AND ITS MANAGEMENT Definitions Stages and Phases of Normal Labour Abnormal P atterns of Labour Classification of Abnormal Labour/Dystocia Diagnosis and Management of Abnormal Labour

3. DEFINITION OF NORMAL AND ABNORMAL LABOUR

4. ABNORMAL LABOUR ALSO CALLED DYSTOCIA

5. DYSTOCIA Dystocia is a Greek word “Dys” meaning difficult, painful, disordered, abnormal, & “Tokos” meaning birth

6. NORMAL STAGES OF LABOUR

7. Cervix relaxes causing it to dilate and thin out Divided into two phases active phase and latent phase Stage#1 Uterine contractions increases in strength and the infant is delivered Stage#2 The placenta and fetal membrane is delivered Stage#3

8. ABNORMAL PATTERNS OF LABOUR Prolonged L atent Phase Protracted Active Phase Arrest P hase

9. PROLONGED LATENT PHASE

10. MANAGEMENT OF PROLONGED LATENT PHASE There are two alternative courses of action Allow the labour to continue Undertake an operative procedure

11. PROTRACTED ACTIVE PHASE Average 8hr 5hr

12. M AGEMENT OF PROTRACTED ACTIVE PHASE Simply observe the patient because it is recognized as a risk factor for perinatal mortality

13. ARREST PHASE

14. MANAGEMENT OF ARREST PHASE Augment the patient by oxytocin C section in case of malpresentation and CPD

15. CLASSIFICATION OF DYSTOCIA Abnormalities of the Power Abnormalities of the Passage Abnormalities of the Passenger

16. CHARACTERSTICS OF POWER Three contractions in 10mints Well synchronized Regular uterine contractions Intensity is greater in f undus

17. UTERINE DYSFUNCTION Hypotonic Dysfunction Infrequent Insufficient Irregular Hypertonic Dysfunction Dyssynchronous More than regular Increase frequency

18. MANAGEMENT Hypotonic Dysfunction Give oxytocin Hypertonic Dysfunction Sedate the patient by giving sedatives Do not give oxytocin

19. ABNORMALITIES OF THE PASSAGE Bony pelvis Contracted pelvis Deformed pelvis Soft tissue obstruction Abnormal placenta location Scarring of birth canal Mass or Neoplasia

20. ABNORMALITIES OF THE PASSENGER Malposition and malpresentation Fetal macrosomia Shoulder dystocia Fetal malformation

21. MALPOSITION Position other than the left occipitoanterior (LOA) is termed as malposition CAUSES : Multipara with pendulous abdomen Android pelvic brim Flat sacrum By chance

22. MALPRESENTATION When the presenting part of the fetus is other than the vertex, it is termed as Malpresentation .

23. It occurs in 3% of the labour CAUSES : Fibroids Oligohydramnios Polyhydramnios Congenital abnormalities Multipara BREECH PRESENTATON

24. FETALMACROSOMIA Fetal macrosomia is used to describe a newborn who's significantly larger than average. A baby diagnosed with fetal macrosomia has a birth weight of more than 8 pounds, 13 ounces (4,000 grams), regardless of his or her gestational age.

25. SHOULDER DYSTOCIA Shoulder dystocia  is a specific case of  obstructed labour  whereby after the delivery of the head, the anterior shoulder of the  infant cannot pass below, or requires significant manipulation to pass below the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head.

26. FETAL MALFORMATION A physical defect present in a baby at birth that can involve many different parts of the body, including the brain, heart, lungs, liver, bones, and intestinal tract. Congenital malformation can be genetic, it can result from exposure of the fetus to a malforming agent or it can be of unknown origin.

27. THANK YOU