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    Obstructed Labour

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    Afra Ashique
    This document discusses the effects of obstructed labor on both mother and fetus. For the mother, immediate effects include exhaustion, dehydration, metabolic acidosis, and genital sepsis. Long term effects can include fistulas and vaginal atresia. For the fetus, risks include asphyxia, acidosis, intracranial hemorrhage, and infection. Clinical features of obstructed labor include strong uterine contractions, an early rupture of membranes, and the formation of a pathological retraction ring between the contracted upper uterine segment and stretched lower segment.

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    Obstructed Labour

    Uploaded by

    Afra Ashique
    190 views10 pages
    This document discusses the effects of obstructed labor on both mother and fetus. For the mother, immediate effects include exhaustion, dehydration, metabolic acidosis, and genital sepsis. Long term effects can include fistulas and vaginal atresia. For the fetus, risks include asphyxia, acidosis, intracranial hemorrhage, and infection. Clinical features of obstructed labor include strong uterine contractions, an early rupture of membranes, and the formation of a pathological retraction ring between the contracted upper uterine segment and stretched lower segment.

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    This document discusses the effects of obstructed labor on both mother and fetus. For the mother, immediate effects include exhaustion, dehydration, metabolic acidosis, and genital sepsis. Long term effects can include fistulas and vaginal atresia. For the fetus, risks include asphyxia, acidosis, intracranial hemorrhage, and infection. Clinical features of obstructed labor include strong uterine contractions, an early rupture of membranes, and the formation of a pathological retraction ring between the contracted upper uterine segment and stretched lower segment.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    190 views10 pages

    Obstructed Labour

    Uploaded by

    Afra Ashique
    This document discusses the effects of obstructed labor on both mother and fetus. For the mother, immediate effects include exhaustion, dehydration, metabolic acidosis, and genital sepsis. Long term effects can include fistulas and vaginal atresia. For the fetus, risks include asphyxia, acidosis, intracranial hemorrhage, and infection. Clinical features of obstructed labor include strong uterine contractions, an early rupture of membranes, and the formation of a pathological retraction ring between the contracted upper uterine segment and stretched lower segment.

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    OBSTRUCTED LABOUR

    EFFECTS ON MOTHER AND FETUS


    CLINICAL FEATURES

    Afra Ashique
    18M013
    EFFECTS ON THE MOTHER - IMMEDIATE

     1) Exhaustion is due to a constant agonizing pain and anxiety.


     2) Dehydration is due to increased muscular activity without adequate fluid intake.
     3) Metabolic acidosis is due to accumulation of lactic acid and ketones.
     4) Genital sepsis is an invariable accompaniment, especially after rupture of the
    membranes with repeated vaginal examination or attempted manipulation outside.
    EFFECTS ON THE MOTHER - IMMEDIATE

     5) Injury to the genital tract includes rupture of the uterus which may be
    spontaneous in multiparae or may be traumatic following instrumental delivery.
     6) Postpartum hemorrhage and shock may be due to isolated or combined effects
    of atonic uterus or genital tract trauma. All these lead to an increased maternal
    morbidity and mortality. The deaths are due to rupture of the uterus, shock and
    sepsis with metabolic changes
    EFFECTS ON THE MOTHER - REMOTE

     1) genitourinary fistula or rectovaginal fistula


     2) variable degree of vaginal atresia
     3) secondary amenorrhea following hysterectomy due to rupture
    EFFECTS ON THE FETUS

     (1) Asphyxia results from tonic uterine contraction that interferes with the
    uteroplacental circulation or due to cord prolapse, especially in shoulder presentation.
     2) Acidosis due to fetal hypoxia and maternal acidosis.
     3) Intracranial hemorrhage is due to supermoulding of the head leading to tentorial
    tear or due to traumatic delivery.
     4) Infection.
    CLINICAL FEATURES

     When there is some mechanical obstruction to the course of labour, contractions become stronger and stronger
    in an attempt to overcome the obstruction.
     The membranes usually rupture early and the presenting part is loosely applied to the cervix .The upper
    segment contracts and retracts, while the lower segment dilates
     With each contraction there is some myometrial shortening, so that the actively contracting upper segment
    becomes progressively thicker and shorter. The passive lower segment becomes progressively stretched and
    thinner. The junction between the two segments stands out prominently as a pathological retraction ring or
    Band ring, which runs obliquely over the abdomen and may climb upwards progressively. At this stage, in a
    multiparous woman, the uterus will continue to contract violently and rupture may occur unless immediate
    intervention is carried out. If a partogram is being used, impending obstruction can be recognised early.
    GENERAL EXAMINATION

     The mother is exhausted, dehydrated, febrile and urine may show ketone bodies.
    ABDOMINAL EXAMINATION

     Uterus may be tonically contracted over the fetus.


     Upper segment is hard and tender.Lower segment is distended and tender. Upper and
    lower segments will be sharply demarcated
     Bandl ring running obliquely over the uterus and rising up
     Difficulty in palpating fetal parts
     Evidence of fetal distress
    VAGINAL EXAMINATION

     Vagina is usually dry and there may be offensive discharge


    THANK YOU

     Reference-DC Dutta’s Textbook of Obstetrics, Textbook of Obstetrics By Sheila Balakrishnan

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