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Prolonged Labor: Definition and Causes

Prolonged labor is defined as the first stage lasting more than 18 hours for primiparous women or more than 14 hours for multiparous women, or a second stage lasting more than 2 hours for primiparous women or more than 1 hour for multiparous women. Prolonged labor can be caused by issues with the cervix, fetus, pelvis, or membranes. It requires close monitoring of the fetus and mother's vital signs and treatment may include augmentation, analgesia, operative delivery, or cesarean section. General treatment includes IV access, hydration, and antibiotics if infection is a risk.

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Madhu Sudhan Pandeya
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745 views8 pages

Prolonged Labor: Definition and Causes

Prolonged labor is defined as the first stage lasting more than 18 hours for primiparous women or more than 14 hours for multiparous women, or a second stage lasting more than 2 hours for primiparous women or more than 1 hour for multiparous women. Prolonged labor can be caused by issues with the cervix, fetus, pelvis, or membranes. It requires close monitoring of the fetus and mother's vital signs and treatment may include augmentation, analgesia, operative delivery, or cesarean section. General treatment includes IV access, hydration, and antibiotics if infection is a risk.

Uploaded by

Madhu Sudhan Pandeya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Prolonged labor

Prepared by:

Dr. Gehanath Baral


MBBS,DGO,MD
Senior Consultant Gynecologist & Obstetrician: Government of Nepal
Visiting Professor: CTGU
29th Mar,2007

1
Definition
• 1st + 2nd stage • Cx dilatation
>18hrs – <1cm/hr (in primi) x
• Latent phase 4hrs
– >20hrs in primi. – <1.5cm/hr (in multi.) x
– >14hrs in multi. 4hrs
• 2nd stage
– >2hrs in primi. • Descent
– >1hr in multi. – <1cm/hr (in primi.) x
4hrs
• 3rd stage >30min. – <2cmhr (in multi.) x
4hrs

2
Cause: Latent phase

1. Cx:- Unripe
2. Fetus:-
• Malposition
• Malpresentation
3. Pelvis:- CPD
4. Membrane:- PROM

3
Cause: 1st stage:

1. Uterine power-
– Uterine inertia
– Incoordinate contraction
2. Birth passage-
– Contracted pelvis
– Cx dystocia
– Pelvic tumors
3. Faulty fetus-
– Malposition,
– Malpresentation
– Hydrocephalous
4
Cause:2nd stage

1. Power-
– Inertia
– Epidural analgesia
– Poor maternal effort
– Constriction ring

• Passage-
– CPD
– Perineal scar
– Pelvic tumor

1. Fetus-
– Malposition,
– Malpresentation
– Hydrocephalous
– Big baby

5
Risks:
Fetal: Maternal:
1. Hypoxia/ Distress 1. Distress

2. Infection 2. PPH

3. Intracranial bleeding 3. Genital tract trauma

4. Operative intervention 4. Operative intervention

5. Puerperal sepsis
6
LabormMonitoring
1. Keep Partograph
2. Examination to confirm diagnosis & cause
– P/A
– P/V
– USG
3. Regular fetal monitoring
4. Regular maternal monitoring
– Vital signs
– Hydration
– Metabolic status

7
Treatment
Definitive: General:
1. Augmentation
– ARM 1. I/V access
– Oxytocin
2. Analgesia or Sedation 2. Hydration
3. Operative delivery
– Forceps or Vacuum 3. Prophylactic antibiotics
– CS if risk of infection

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