Abnormal Labour in Obstetrics

Definition and Incidence

• Abnormal labour, also known as dystocia, refers to a labour that deviates from the normal progress of labour.
• Incidence: 10-15% of all deliveries are considered abnormal labour.

Causes of Abnormal Labour

• Fetal macrosomia (large baby)
• Multiple pregnancy
• Placenta previa
• Abnormal fetal presentation (e.g. breech, transverse lie)
• Uterine anomalies (e.g. septate uterus)
• Maternal medical conditions (e.g. hypertension, diabetes)
• Obesity
• Previous uterine surgery

Types of Abnormal Labour

• Prolonged labour: Labour that lasts longer than expected for the stage of labour.
  • Primary prolonged labour: Slow progress in the active phase of labour.
  • Secondary prolonged labour: Labour that slows down or arrests after a period of normal progress.
• Arrest of labour: Labour that stops progressing despite adequate uterine contractions.
• Obstructed labour: Labour that is hindered by a mechanical obstruction, such as a narrow pelvis or a large baby.

Complications of Abnormal Labour

• Maternal complications:
  • Infection
  • Postpartum hemorrhage
  • Uterine rupture
• Fetal complications:
  • Fetal distress
  • Birth asphyxia
  • Neonatal morbidity

Management of Abnormal Labour

• Identification of the underlying cause
• Close fetal monitoring
• Augmentation of labour with oxytocin
• Instrumental delivery (e.g. forceps, vacuum extraction)
• Caesarean section
• In some cases, termination of pregnancy may be necessary

Definition and Incidence of Abnormal Labour

• Abnormal labour, also known as dystocia, is a labour that deviates from the normal progress of labour.
• 10-15% of all deliveries are considered abnormal labour.

Causes of Abnormal Labour

• Fetal macrosomia (large baby) can cause abnormal labour.
• Multiple pregnancy increases the risk of abnormal labour.
• Placenta previa is a cause of abnormal labour.
• Abnormal fetal presentation (e.g. breech, transverse lie) can lead to abnormal labour.
• Uterine anomalies (e.g. septate uterus) can cause abnormal labour.
• Maternal medical conditions (e.g. hypertension, diabetes) increase the risk of abnormal labour.
• Obesity is a risk factor for abnormal labour.
• Previous uterine surgery can cause abnormal labour.

Types of Abnormal Labour

• Prolonged labour lasts longer than expected for the stage of labour.
• Primary prolonged labour is slow progress in the active phase of labour.
• Secondary prolonged labour is labour that slows down or arrests after a period of normal progress.
• Arrest of labour is labour that stops progressing despite adequate uterine contractions.
• Obstructed labour is labour hindered by a mechanical obstruction, such as a narrow pelvis or a large baby.

Complications of Abnormal Labour

• Maternal complications include infection, postpartum hemorrhage, and uterine rupture.
• Fetal complications include fetal distress, birth asphyxia, and neonatal morbidity.

Management of Abnormal Labour

• The underlying cause of abnormal labour must be identified.
• Close fetal monitoring is necessary in cases of abnormal labour.
• Augmentation of labour with oxytocin may be necessary.
• Instrumental delivery (e.g. forceps, vacuum extraction) may be required.
• Caesarean section may be necessary in some cases.
• In some cases, termination of pregnancy may be necessary.

This quiz covers the definition, incidence, and causes of abnormal labour, also known as dystocia. Learn about the factors that contribute to abnormal labour and how it affects deliveries.