OBSTRUCTED LABOUR: OBSTRUCTED LABOUR 3/24/2014 1
OBSTRUCTED LABOUR: OBSTRUCTED LABOUR 3/24/2014 2 Dr Balina Moses balinamoses@gmail.com http://balinamoses.blogspot.com
Contents: Contents Definition Epidemiology Causes Clinical features Differential diagnosis Investigations Management Complications Prevention Prognosis 3/24/2014 3
PowerPoint Presentation: Normal Labour 3/24/2014 4
Case: Case A 34 year old female, with a known uterine septum, G5P4+0 came to the maternity ward at 39 weeks with regular UCs. Exam showed footling breech. Cervix was 6cm long with bulging membranes. While examining, the BOW suddenly ruptured and a loop of umbilical cord protruded through the cervix between the fetal extremities. 3/24/2014 5
Definition: Definition Obstructed labour is the failure of the presenting part of the fetus to descend through the birth canal, because there is an impossible barrier preventing its descent, despite strong uterine contractions. 3/24/2014 6
PowerPoint Presentation: 3/24/2014 7 Epidemiology KIUTH – Kampala International University Teaching Hospital
PowerPoint Presentation: 3/24/2014 8 Epidemiology KIUTH – Kampala International University Teaching Hospital
PowerPoint Presentation: Epidemiology 3/24/2014 9
PowerPoint Presentation: Epidemiology 3/24/2014 10
PowerPoint Presentation: Epidemiology 3/24/2014 11
PowerPoint Presentation: World wide Prevalence is 2-8% Maternal mortality rate is 8% Epidemiology 3/24/2014 12
Causes of obstructed labour: Causes of obstructed labour Powers 3/24/2014 13
PowerPoint Presentation: Causes of obstructed labour 3/24/2014 14
PowerPoint Presentation: Causes of obstructed labour 3/24/2014 15
PowerPoint Presentation: Causes of obstructed labour 3/24/2014 16
PowerPoint Presentation: Causes of obstructed labour 3/24/2014 17
PowerPoint Presentation: Causes of obstructed labour 3/24/2014 18
PowerPoint Presentation: Causes of obstructed labour 3/24/2014 19
Causes of obstructed labour: Powers Passenger Causes of obstructed labour 3/24/2014 20
PowerPoint Presentation: Hydrocephalus Causes of obstructed labour 3/24/2014 21
PowerPoint Presentation: Malposition Malpresentation Causes of obstructed labour 3/24/2014 22
PowerPoint Presentation: Shoulder Dystocia Causes of obstructed labour 3/24/2014 23
PowerPoint Presentation: Conjoined Twins Causes of obstructed labour 3/24/2014 24
PowerPoint Presentation: Conjoined Twins Causes of obstructed labour 3/24/2014 25
PowerPoint Presentation: Conjoined Twins Causes of obstructed labour 3/24/2014 26
Causes of obstructed labour: Powers Passenger Passage Causes of obstructed labour 3/24/2014 27
PowerPoint Presentation: Inadequate Pelvis Causes of obstructed labour 3/24/2014 28
PowerPoint Presentation: Umbilical Cord Prolase Causes of obstructed labour 3/24/2014 29
PowerPoint Presentation: Female Circumcision Causes of obstructed labour 3/24/2014 30
Clinical features: Prolonged labour Mother appears weak Abnormal vital signs 3/24/2014 31 Clinical features General examination
Clinical features: Malpresentation Bandl’s ring 3/24/2014 32 Clinical features Abdominal examination
Clinical features: Clinical features 3/24/2014 33 Abdominal examination Bandl’s ring
Clinical features: Foul smelling meconium Oedema of the vulva and cervix Caput on the fetal head 3/24/2014 34 Clinical features Vaginal examination
Differential diagnosis: Full bladder Fundal myoma 3/24/2014 35 Differential diagnosis
Investigations: 3/24/2014 36 Investigations Partograph
Investigations: Investigations CBC Serum electrolytes Sonography TAUS 3/24/2014 37 Blood Imaging
Management: Rehydration Catheterization Caesarean delivery 3/24/2014 38 Management
Complications: Fistula PPH Slow involution Shock Paralytic ileus Sepsis Death 3/24/2014 39 Complications Maternal
Complications: Neonatal sepsis Convulsions Facial injury Severe asphyxia Death 3/24/2014 40 Complications Fetal
Prevention: Skilled birth attendance Using the partograph Birth preparedness Nutritional education Delaying early marriage 3/24/2014 41 Prevention
Prognosis: The prognosis of subsequent pregnancies depends on the cause for obstructed labour. 3/24/2014 42 Prognosis