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Prolonged Labour PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "PROLONGED LABOUR” by Hassan, MD.

This medical PowerPoint presentation is about prolonged labor, also known as prolonged or extended labor. Prolonged labor is a condition in which the active phase of labor (when the cervix is dilating) lasts longer than expected. The World Health Organization (WHO) defines prolonged labor as lasting more than 12 hours in nulliparous women (women giving birth for the first time) and more than 10 hours in multiparous women (women who have previously given birth).

Prolonged labor can occur for various reasons, including:

Weak or inefficient contractions
Fetal malposition, such as a breech or posterior presentation
Large fetal size
Maternal exhaustion or dehydration
Cephalopelvic disproportion, which means the babys head is too large to fit through the mothers pelvis

Prolonged labor can have negative consequences for both the mother and the baby. For the mother, it can lead to exhaustion, dehydration, and infection. It can also increase the likelihood of interventions, such as the use of forceps or vacuum extraction, or a cesarean section. For the baby, prolonged labor can increase the risk of fetal distress, low oxygen levels, and infection.

Management of prolonged labor depends on the cause. In some cases, rest, hydration, and pain relief may be sufficient to allow labor to progress. In other cases, interventions such as oxytocin (a medication that can stimulate contractions), artificial rupture of membranes, or cesarean section may be necessary.

Its important for pregnant women to attend regular prenatal visits with their healthcare provider to monitor the progress of their pregnancy and identify any potential risks for prolonged labor.

Tags : prolonged labor, extended labor, active phase of labor, nulliparous women, Obstetrics and Gynecology, Obstetrics and Gynecology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 2186 | Downloads : 1

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Slide 1-

PROLONGED LABOUR Hassan, MD
Slide 2-

PROLONGED FIRST STAGE OF LABOUR Diagnosis Deviation of line of cervical dilatation to the right of the alert line and reaches the action line. Causes 1. Powers i.e. uterine contractions 2. Passenger i.e. the fetus 3. Passage i.e. the pelvis.
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Prolonged Latent Phase Diagnosis Diagnosis of labor has been made but progressive cervical change occurs but at an inordinately slow pace Causes Unripe cervix, false labor, sedation, uterine inertia Complications Maternal fatigue/exhaustion due to lack of sleep, Maternal dehydration that can lead to a combination of contractures and contractions
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Prolonged Active Phase Causes Power: Ineffective contractions Either they space out or have less strength to get the effect needed. Causes - maternal fatigue, pain (catacholamine response), overmedication either in dose or timing. Passenger: Big baby, malposition/presentation Passage: contracted pelvis
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PROLONGED FIRST STAGE OF LABOUR Active management of labour Indications Accurate diagnosis of Labour Primigravidae Singleton fetus Vertex presentation No evidence of fetal distress
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PROLONGED SECOND STAGE OF LABOR Diagnosis When the time exceeds 2 hours Causes: Descent abnormalities Fetal position/malpresentation/size Ineffective contractions Ineffective maternal effort Medications/anesthesia
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PROLONGED SECOND STAGE OF LABOUR Management Depends on the cause. Poor uterine activity may be corrected by augmentation. Poor maternal effort or exhaustion - assisted delivery (as long as all the pre-requisites have been fulfilled).
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PROLONGED THIRD STAGE OF LABOUR Diagnosis When exceeds 30 minutes Causes Uterine atony Big uterus due to poly, multiple pregnancy, myoma, following prolonged labour, traumatic delivery, excessive analgesia, anaesthesia Uterine abnormalities – uterus & cervix
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PROLONGED THIRD STAGE OF LABOUR Causes 3. Placental abnormalities Problems of adhesion: placenta praevia, cornual implantation, accreta, pancreta etc 4. Mismanagement of 3rd stage Massage of uterus before delivery of the placenta may lead to tetanic contractions, Admin of ergot preparations too early or too late sustained uterine contration –traps the placenta
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Occipito-Posterior Positions and Deep Transverse Arrest Occiput usually lateral when head engages 80% will rotate to anterior during labour POPP Causes delay in lst stage. More common in primigravidae. Treatment if inefficient uterus action may result in rotation to anterior.
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Occipito Posterior Position Causes Anteriorly situated placenta Anthropoid pelvis Flat Sacrum Pundulous abdomen Chance R.O.P. three times as common as L.O.P.
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Occipito Posterior Position Management 12% will deliver spontaneously O.P. Transverse arrest may require operative intervention Lack of progress may warrant c-section Vacuum preferable to Forceps (?)
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Complications of prolonged obstructed labour Maternal Infection – sepsis, peritonitis, wound infection, Fistula Thrombo-embolism Ruptured Uterus PPH Broad Ligament Haematoma Shock Paralytic ileus Burst abdomen
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Fetal complications Cord Prolapse Birth Asphyxia Meconium Aspiration Syndrome Convulsion Jaundice Neonatal Sepsis/Septicemia Diarrhoea Birth injury
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An overview on pathophysiology of prolonged obstructed labour Maternal exhaustion and distress Hypovolaemia Electrolyte imbalance Thrombo-embolism Other cpxs Ruptured Uterus PPH Obstetric fistulae Infection, paralytic ileus
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Management of prolonged obstructed labour Resuscitation: IV fluids RL or NS 1-2 Lfast, use large bore cannula Catheterization – continuous bladder drainage Blood gpg & x-matching Antibiotics: i.v Ampicilin & metronidazole, ceftriaxone Deliver the mother by CS
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PRECIPITOUS LABOR Cervical dilatation rate >5cm/hr dilatation in nullips; >10cm/hr in multips Complications of precipitous labor Trauma to birth canal; Fetal distress; and Postpartum hemorrhage