Definition of "Obstructed labour"

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Obstructed labour (aka labour dystocia) is when, even though the uterus is contracting normally, the baby doesn't exit the pelvis during childbirth, due to being physically blocked.

Cause
  • Large or abnomally positioned baby, including shoulder dystocia (i.e. where the anterior shoulder doesn't pass easily below the pubic bone)
  • Small pelvis, of which risk factors for a small pelvis include:
    • Malnutrition
    • Lack of exposure to sunlight, causing vitamin D deficiency
    • More common in adolescence, as the pelvis may not have finished growing
  • Problems w/ birth canal, including narrow vagina and perineum, which may be due to female genital mutilation or tumors
Ix
  • Partograph, to track labour progression and Dx problems
Tx
  • C-section
  • Vacuum extraction
  • Possible symphysiotomy (surgical opening of the pubic symphysis)
  • Keeping the woman hydrated
  • Antibiotics, if the membranes have been ruptured for >18 hours
Prognosis
  • Results in "prolonged labour" (i.e. active phase of labour >12 hours)
  • Complications for the baby include not getting enough oxygen, which may result in death
  • Increases the risk of:
    • Mother getting infection
    • Mother having uterine rupture
    • Mother having post-partum bleeding
  • Long term complications for the mother include obstetrical fistula
Epidemiology
  • Obstructed labour affects 3.5% of deliveries
  • It results in 19k deaths per annum
  • Most deaths occur in the developin world
See also

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Definition of Obstructed labour | Autoprac


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