Abnormal Labour in Pregnancy

Definition and Incidence

• Abnormal labour is a deviation from the normal labour process, which can lead to complications for the mother and fetus.
• Incidence: approximately 1 in 5 women experience abnormal labour.

Types of Abnormal Labour

• Prolonged Labour: labour lasting >12 hours in primigravida (first-time mother) or >6 hours in multigravida (mother who has given birth before).
• Arrest of Labour: labour that ceases to progress despite adequate uterine contractions.
• Obstructed Labour: labour complicated by mechanical obstruction, e.g., fetal macrosomia or cephalopelvic disproportion.
• Precipitate Labour: labour that progresses rapidly, often resulting in fetal distress or maternal complications.

Causes of Abnormal Labour

• Fetal Factors:
  • Fetal macrosomia
  • Fetal malposition (e.g., breech presentation)
• Maternal Factors:
  • Uterine anomalies (e.g., septate uterus)
  • Previous uterine surgery
  • Obesity
• Placental Factors:
  • Placenta previa
  • Placental abruption

Complications of Abnormal Labour

• Maternal Complications:
  • Infection
  • Haemorrhage
  • Uterine rupture
• Fetal Complications:
  • Fetal distress
  • Birth asphyxia
  • Neonatal morbidity and mortality

Management of Abnormal Labour

• Cesarean Section: may be necessary in cases of prolonged labour, obstructed labour, or fetal distress.
• Instrumental Delivery: forceps or ventouse may be used to assist delivery in cases of fetal distress or maternal exhaustion.
• Oxytocin Augmentation: oxytocin infusion to stimulate uterine contractions in cases of prolonged labour or arrest of labour.

Abnormal Labour

• Deviation from the normal labour process, leading to complications for the mother and fetus.
• Approximately 1 in 5 women experience abnormal labour.

Types of Abnormal Labour

• Prolonged Labour: labour lasting >12 hours in primigravida (first-time mother) or >6 hours in multigravida (mother who has given birth before).
• Arrest of Labour: labour that ceases to progress despite adequate uterine contractions.
• Obstructed Labour: labour complicated by mechanical obstruction, e.g., fetal macrosomia or cephalopelvic disproportion.
• Precipitate Labour: labour that progresses rapidly, often resulting in fetal distress or maternal complications.

Causes of Abnormal Labour

• Fetal Factors:
  • Fetal macrosomia (large fetus)
  • Fetal malposition (e.g., breech presentation)
• Maternal Factors:
  • Uterine anomalies (e.g., septate uterus)
  • Previous uterine surgery
  • Obesity
• Placental Factors:
  • Placenta previa
  • Placental abruption

Complications of Abnormal Labour

• Maternal Complications:
  • Infection
  • Haemorrhage
  • Uterine rupture
• Fetal Complications:
  • Fetal distress
  • Birth asphyxia
  • Neonatal morbidity and mortality

Management of Abnormal Labour

• Cesarean Section: may be necessary in cases of prolonged labour, obstructed labour, or fetal distress.
• Instrumental Delivery: forceps or ventouse may be used to assist delivery in cases of fetal distress or maternal exhaustion.
• Oxytocin Augmentation: oxytocin infusion to stimulate uterine contractions in cases of prolonged labour or arrest of labour.