presentation on Precipitate labour and its management

What is precipitous labor?
Precipitous labor (or rapid labor) describes labor that’s quick and short. If you have a precipitous labor, your baby is born within three hours of regular contractions starting. Contractions are when your uterine muscles tighten and relax to help push your baby out. Typical labor lasts between six and 18 hours on average. While fast labor might sound better than labor that lasts several hours (or days), precipitous labor comes with risks to both the birth parent and baby.

How fast is precipitous labor?
Precipitous labor is when your baby comes within three hours of your first regular contraction. Some healthcare providers consider precipitous labor to be anything less than five hours.

What are the signs of precipitous labor?
The symptoms of rapid labor vary. However, it’s likely to include one of the following:

Contractions start suddenly and come very close together right away. Unlike typical labor, there isn’t a break between contractions.
Continuously painful and strong contractions with little to no build up in intensity level.
You feel an urge to push. Some people describe it as feeling like you need to poop.
With normal labor, contractions start slowly and are weak. They are hard to predict and may occur at irregular intervals. This process can last hours or even days. In precipitous labor, the slow and weak contractions never happen. A person experiences fast, intense contractions almost from the get-go.

What causes precipitous labor?
No one knows for sure what causes precipitous labor, however, some factors may increase your chances for rapid labor.

What are risk factors for precipitous labor?
Several factors can increase your risk for precipitous labor:

You’ve given birth before.
You’ve had precipitous labor before.
Your baby is on the smaller side.
Your uterus is exceptionally strong and efficient at contractions.
Your birth canal is soft and flexible.
You have high blood pressure.
Your labor is induced with prostaglandins.
You’ve been exposed to certain drugs such as cocaine.
Talk to your healthcare provider if you think you might be at risk for precipitous labor. They can review your medical history and help determine if you need to take precautions.

What are the complications of precipitous labor?
Rapid labor is unplanned and not how most people expect their birthing experience to happen. This loss of control can be hard to handle, both physically and emotionally. Because it all happens so fast, you may have trouble getting to the hospital and be too late for pain medication or an epidural. This can make for a scary and chaotic delivery.

Other complications for the birth parent include:

Heavy bleeding or postpartum hemorrhage.
Shock (not enough blood and oxygen get to your organs and tissue).
Higher risk of perineal tears and vaginal lacerations.
Retained placenta or placenta getting stuck in the uterus.
Delivery in an unsterilized area, like a car.
Emotional distress.
Not receiving necessary anti

1. PRECIPITATE LABOUR

2. INTRODUCTION Precipitate labour occurs when uterine contractions are so strong that the woman gives birth with only a few,rapidly occurring contractions. Also defined as extremely rapid labour that last less than 2 hours from start to finish

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4. PREVALANCE RATE Precipitate labour -2%

5. CAUSES Multiparity Previous precipitous labour Roomy pelvis Small fetus in a favorable position Strong Uterine contractions Relaxed pelvis and vaginal musculature

6. Maternal risk Lacerations Amniotic fluid embolism Atonic uterus-uterine exhaution Predisposing to PPH Cervical tear Inversion of uterus Abruptio placenta Uterine rupture Delivery in unsterile environment

7. Fetal risk Risk of infection Fetal hypoxia Cerebral trauma/hemorrhage-Rapid compression & decompression of the fetal head Fetal injuries Low apgar score Potential aspiration of Meconium stained liquor Neonatal sepsis

8. SIGNS & SYMPTOMS Sudden onset of intense /Increased pain Tachycardia, Increased body temperature & BP Nasal flaring Anxiety Restlessness Hypertonic contraction Sensation of pressure including urge to push that comes on quickly without warning Even No symptoms with cervical dilataion

9. MANAGEMENT BEFORE DELIVERY Assess for previous labour h/o Make the patient to lie down in clean space Advise to take deep breath and diversional therapy Close monitor- contractions, dilatation,fetal status Oxytocin augmentation should be avoided Tocolytics - terbutaline,mgso4 Ready with delivery kit

10. DURING DELIVERY Liberal Episiotomy Delivery of head should be controlled Apply gentle pressure anteriorly against the fetal head to maintain flexion & prevent it from delivering too quickly

11. AFTER DELIVERY Examine mother and fetus