Precipitate labour

PROFESSOR

1. PRECIPITATE LABOUR Britto.v Associate professor in nursing

2. DEFINITION: A labour is called precipitate when the combined duration of the first and second stage is less than two hours.

3. INCIDENCE It is common in multipara and may be repetitive. Rapid expulsion is due to the combined effect of hyperactive uterine contractions associated with diminished soft tissue resistance. Labour is short as the rate of cervical dilatation is 5cm per hour or more for the nulliparous women.  

4. MATERNAL RISKS; It includes Extensive laceration of the cervix, vagina and pernium (to the extent of complete perineal tear) PPH due to uterine hypotonia that develops subsequent to unusual vigorous contractions Inversion Infection Uterine rupture Aminiotic fluid embolism

5. FETAL RISKS: It include Intracranial stress and haemorrhage because of rapid expulsion without time for moulding of the head. The baby may sustain serious injuries if delivery occurs in standing position ,bleeding from the torn cord and direct hit on the skull are real hazards .

6. TREATEMENT: The patient having previous history of precipitate labour should be hospitalised prior to labour. During labour, the uterine contraction may be suppressed by administering ether or magnesium sulphate during contractions. Delivery of the head should be controlled. Episiotomy should be done liberally . Elective induction of labour by low rupture of membranes and conduction of controlled delivery is helpful . Oxytocin augmentation should be avoided.

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