Abnormal Labour and Dystocia

Study Notes

Definition

Abnormal labour, also known as dystocia, refers to a labour that does not progress normally, resulting in complications for the mother and/or fetus.

Causes

Fetal factors:
- Abnormal fetal position or presentation (e.g. breech, transverse)
- Macrosomia (fetal macrosomia)
- Multiple gestations
Maternal factors:
- Uterine abnormalities (e.g. uterine septum, fibroids)
- Pelvic abnormalities (e.g. pelvic contraction)
- Obstetric complications (e.g. placenta previa, abruption)
- Medical conditions (e.g. hypertension, diabetes)
Other factors:
- Protracted labour
- Inadequate uterine contractions
- Ineffective pushing

Types

Prolonged labour:
- Primary prolonged labour: labour lasting > 20 hours in nulliparas or > 14 hours in multiparas
- Secondary prolonged labour: labour lasting > 8 hours in nulliparas or > 6 hours in multiparas
Arrest of labour:
- Failure to progress in the active phase of labour
Abnormal fetal heart rate:
- Non-reassuring fetal heart rate patterns

Complications

Maternal complications:
- Infection
- Hemorrhage
- Uterine rupture
- Vaginal lacerations
Fetal complications:
- Fetal distress
- Birth asphyxia
- Meconium aspiration syndrome
Neonatal complications:
- Low Apgar score
- Birth trauma

Management

Augmentation of labour:
- Oxytocin administration
- Artificial rupture of membranes
Cesarean delivery:
- Indicated for fetal distress, failed induction, or maternal complications
Instrumental delivery:
- Forceps or vacuum extraction may be used in cases of fetal distress or maternal exhaustion
Analgesia and anaesthesia:
- Epidural anaesthesia may be used to manage pain and facilitate delivery

Abnormal Labour (Dystocia)

Labour that does not progress normally, resulting in complications for the mother and/or fetus.

Causes of Abnormal Labour

Fetal factors:
- Abnormal fetal position or presentation (e.g. breech, transverse)
- Macrosomia (fetal macrosomia)
- Multiple gestations
Maternal factors:
- Uterine abnormalities (e.g. uterine septum, fibroids)
- Pelvic abnormalities (e.g. pelvic contraction)
- Obstetric complications (e.g. placenta previa, abruption)
- Medical conditions (e.g. hypertension, diabetes)
Other factors:
- Protracted labour
- Inadequate uterine contractions
- Ineffective pushing

Types of Abnormal Labour

Prolonged Labour

Primary prolonged labour: labour lasting > 20 hours in nulliparas or > 14 hours in multiparas
Secondary prolonged labour: labour lasting > 8 hours in nulliparas or > 6 hours in multiparas

Arrest of Labour

Failure to progress in the active phase of labour

Abnormal Fetal Heart Rate

Non-reassuring fetal heart rate patterns

Complications of Abnormal Labour

Maternal Complications

Infection
Hemorrhage
Uterine rupture
Vaginal lacerations

Fetal Complications

Fetal distress
Birth asphyxia
Meconium aspiration syndrome

Neonatal Complications

Low Apgar score
Birth trauma

Management of Abnormal Labour

Augmentation of Labour

Oxytocin administration
Artificial rupture of membranes

Cesarean Delivery

Indicated for fetal distress, failed induction, or maternal complications

Instrumental Delivery

Forceps or vacuum extraction may be used in cases of fetal distress or maternal exhaustion

Analgesia and Anaesthesia

Epidural anaesthesia may be used to manage pain and facilitate delivery

Description

This quiz covers the causes and complications of abnormal labour, also known as dystocia, including fetal and maternal factors. Learn about the different types of abnormal fetal position and maternal uterine and pelvic abnormalities.