PRECIPI T A TE LABOUR Mrs. Deepti Kukreti PG Nursing Tutor Obstetrics & Gynaecology
DEFINITION A labour precipitate i s c alled when the combined duration of the first and second stage is less than two hours.
INC I DENCE 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.
MATERNAL RISKS; It includes e x t ensi v e lace r a tion of the ce r vi x , v agina a n d pernium (to the extent of complete perineal tear) PPH du e t o u t e r i n e h yp o t oni a th a t d ev e l o p s subsequent to unusual vigorous contractions Inversion Infection Uterine rupture Aminiotic fluid embolism
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 .
TREATEMENT: Th e 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.