obstructed labour. pptx Abnormal labour

Definition:
Obstructed labor, also known as dystocia, occurs when a baby cannot progress through the birth canal despite strong uterine contractions. This can be due to various factors that impede the normal passage of the baby.

Causes:

Cephalopelvic Disproportion (CPD): The baby's head is too large, or the mother's pelvis is too small to allow passage.
Fetal Malposition: The baby is in an abnormal position, such as breech (feet or buttocks first) or transverse (sideways).
Fetal Malpresentation: The presenting part (usually the head) is not aligned correctly with the pelvis.
Uterine Abnormalities: Structural issues like fibroids or congenital uterine malformations.
Multiple Pregnancy: More than one baby in the womb can complicate the labor process.
Obstructions in the Birth Canal: Physical barriers such as pelvic tumors.
Symptoms:

Intense, frequent contractions without progression in labor.
Severe pain due to the pressure and lack of progress.
Signs of fetal distress, such as abnormal heart rate patterns.
Maternal exhaustion and dehydration.
Diagnosis:

Clinical Examination: Assessment of the mother's pelvis and the baby's position.
Ultrasound: To determine the baby's position and size.
Monitoring: Continuous fetal heart rate monitoring to assess distress.
Complications:

For the Mother: Risk of uterine rupture, infection, postpartum hemorrhage, and obstetric fistula.
For the Baby: Risk of birth asphyxia, injury, or stillbirth.
Management:

Positional Changes: Encouraging the mother to move or change positions to facilitate labor.
Medical Interventions: Administration of medications to strengthen contractions.
Surgical Interventions:
Cesarean Section: Often required if labor does not progress.
Operative Vaginal Delivery: Using tools like forceps or a vacuum to assist delivery if the baby is close to being delivered.
Prevention:

Antenatal Care: Regular check-ups to monitor fetal growth and position.
Nutritional Support: Ensuring the mother is well-nourished to reduce risks associated with pelvic size and strength.
Early Detection: Identifying potential risks during pregnancy for timely intervention.
Prognosis:
With timely and appropriate management, most cases of obstructed labor can be resolved safely. However, delayed treatment can lead to severe complications for both mother and baby.

Obstructed labor is a significant cause of maternal and neonatal morbidity and mortality, especially in areas with limited access to emergency obstetric care. Proper prenatal care and access to skilled birth attendants are crucial in preventing and managing this condition.

1. Obstructed labour R Square Nursing Classes

2. Introduction:- After labour is one where is spite good uterine contraction the progress decent of the presenting part is arrested due to mechanical abstruction . This may result either from the fault in the fetus or in the birth canal or both.

3. Causes :- Fault in the passage:- common cause contracted pelvis and cephalo pelvic disproportion. Soft tissue obstruction:- these include for cervical distorcia cervical or broad ligament fibroids and impacted ovarian tumor . Fault in the passenger:- brow presentation congenital Mal formation such as hydrocephalus,fetal asitis . Conjoint twins ,big baby compound presentation locked twins

4. Sign of obstructed labour :- The presenting part does not enter the pelvic bream despite good contraction. As the presenting part does not decent cervical dilation is slow. Late sign:- pyrexia. Rapid pulse rate. Urine output is poor and hematuria may be present. Profound fetal bradycardia. As visible retraction ring aur bandal rings may be seen above the symphysis pubis. Vegina me feel hot and dry.

5. Effect on the mother :- Exhaustion due to constant pain and anxiety . Dehydration due to increased muscles activity. Metabolic acidosis due to accumulation of lactic acid produced by contraction of uterus and voluntary muscles. Intrauterine infection may follow prolonged rupture of membrane. Pph.

6. Effect on the fetus :- Intra uterine asphyxia. Intracranial. Haemorrhage. Neonatal infection. Acidosis. Foetal death.

7. Prevention Good nutritional supply? Since childhood.
Avoid early marriage?
Emergency obstetric Care
Universal ANC is outdated
• Monitor labor using partograph ?
Promote family planning? Services
Maternal waiting area (MWA)? For high risk mothers in remote area
• Elective caesarean delivery? When indicated

8. Management:- General measure :- ►Resuscitation. Oxygen. Antibiotics. ►Catheterization. Pain relief. ►NG tube drainage of gastric content. Hemogram and blood as necessary

9. Cont.. Obstruction relief:- Vaginal Route. Operative Delivery. Destructive Delivery. Abdominal Route.:- Caesarean Delivery. Laparotomy-Uterine repair or Hysterectomy.