1 / 27

Obstructed labour

Obstructed labour. Definition :- obstructed labour can be define as a labour where there is poor or no progress of labour in spite of good uterine contraction. Incidence :- 1 -2% of referral cases in developing country. Causes:-. Maternal condition (fault in the passage):- Contracted pelvis

lorand
Download Presentation

Obstructed labour

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Obstructed labour Definition :- obstructed labour can be define as a labour where there is poor or no progress of labour in spite of good uterine contraction. Incidence :- 1 -2% of referral cases in developing country.

    2. Causes:- Maternal condition (fault in the passage):- Contracted pelvis Abnormal pelvis:- android, anthropoid Pelvic tumor:- fibroid, ovarian tumor Tumor of rectum, bladder or pelvic bone. Abnormality in uterus & vagina:-stenosis in cx. & vagina, contraction ring in uterus, vaginal septum, rigid perineum.

    3. Foetal condition (fault in the passenger):- Macrosomic baby Malpresentation Malposition:- popp, transverse lie Malformed foetus:- hydrocephalus, foetal Ascitis, conjoint twins, cord around the neck. Locked twins

    4. Diagnosis Partograph will recognize impending obstruction early. If the labour is slow to progress, careful general, abdominal and vaginal examination is necessary. Woman gives the history of:- -prolong labour and -the labour pain become severe and frequent and -bearing down.

    5. Examination:- General examination:- Features of maternal distress i.e. Exhaustion & keto acidosis Dehydration Tachycardia >100/m Raise temperature Scanty urine

    6. Abdominal examination :- -The retraction ring (bandl’s ring) is seen and felt between the tonically contracted upper segment of the uterus and the distended , tender and stretched lower segment. Distended urinary bladder. FHS shows evidence of foetal distress or even absent.

    9. Vaginal examination:- The vulva usually swollen and edematous. The vaginal is dry, hot and occasionally offensive and purulent discharge. The cervix is almost fully dilated or hanging like a curtain. The presenting part is extremely moulded and jammed in the pelvis. There is usually large caput formation.

    10. Management Preventive:- Proper assessment of pregnant woman during ANC. Regular ANC visit. Proper assessment in early labour to detect the cause if any. Partograph have to strictly follow. Prompt follow appropriate treatment to solve the problems.

    11. Curative:- Immediate management General management Obstetric management

    12. Immediate management :- Correct maternal dehydration Contraction prevent by tocholytic drugs. Blood sample send for grouping and cross matching.

    13. B. General management :- Assessment of vital of mother and general condition. IV fluid to correct dehydration. Broad spectrum antibiotics. Catheterization. Sodium bicarbonate infusion to correct acidosis.

    14. C. Obstetric management:- 1. Delivery of foetus:- a. Vaginal delivery:- -(destructive opt.) dead foetus -if head is low and vaginal delivery is not risky, forceps extraction may be done in alive foetus also. b. Caesarean section:- -alive foetus -over distended lower segment with impending rupture even the foetus is dead. 2. Active management of 3rd stage of labour. 3. Continuous bladder drainage for 2-3 days to prevent VVF.

    15. Complication

More Related