Prolonged Labor
Original Editor - User:Temitope Olowoyeye
Top Contributors - Temitope Olowoyeye, Gold Oluleye, Kim Jackson, Lucinda hampton and Khloud Shreif
Introduction[edit | edit source]
Labor dystocia is a labor complication common in nulliparous women that may disrupt the the process of vaginal delivery making it a major indication for instrumental deliveries or/ and cesarean section (CS).[1] It may increase the risk for maternal and neonatal infection, fetal distress, neonatal hypoxia, uterine rupture, and postpartum hemorrhage it may also increase the risk of maternal pelvic floor and genital trauma.[2]
Labor dystocia(LD) can not be described without describing the process of normal labor process. Normal labor is described as uterine contractions that leads to progressive dilation and effacement of the cervix. Labor dystocia (LD) caused by fetal malposition, inadequate contractions, poor maternal efforts, or true cephalopelvic disproportion.[3] Management of LD can significantly affect the outcome of the delivery process.
Pathophysiology[edit | edit source]
Labor dystocia can be the result of problems with one of the following three P' s:
Passenger: The passenger is referred to the fetus travelling down the birth canal. When the fetal head is large in proportion to the mother's pelvis, or not in proper position. In this situation, spontaneous vaginal delivery will be difficult and there will be need for assisted delivery or a caesarean section.
Pelvis or passage size:
Power (uterine contractility) to foeto-pelvic disproportion (mechanical dystocia) and/or inadequate contractions (dynamic dystocia) and/or ineffective maternal pushing efforts in the second stage of labor.
Definition
WHO defined labor dystocia as the "onset of regular, rhythmical painful contractions accompanied by cervical dilation where labor is longer than 24 hours".
Resources[edit | edit source]
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References[edit | edit source]
- ↑ (Lowe NK: A Review of factors associated with dystocia and Cesarean section in nulliparous women. J Midwifery womens health. 2007,52(3):216-228, American College of Obstetrics and Gynecology. ACOG practice bulletin number 49, December 2003: dystocia and augmentation of labor. Obstet Gynecol. 2003;102:1445–54.
- ↑ Sheiner E, Levy A, Feinstein U, et al. Risk factors and outcome of failure to progress during the first stage of labor: a population-based study. Acta Obstet Gynecol Scand. 2002 Mar;81(3):222–6. PMID: 11966478.
- ↑ Shields SG, Ratcliffe SD, Fontaine P, Leeman L. Dystocia in nulliparous women. Am Fam Physician. 2007 Jun 1;75(11):1671-8. PMID: 17575657.
