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.