OBSTRUCTED LABOUR: OBSTRUCTED LABOUR 11/21/2013 1
OBSTRUCTED LABOUR: OBSTRUCTED LABOUR 11/21/2013 2 Dr Balina Moses balinamoses@outlook.com http://balinamoses.blogspot.com
Contents: Contents Definition Epidemiology Causes Clinical features Differential diagnosis Investigations Management Complications Prevention Prognosis 11/21/2013 3
PowerPoint Presentation: Normal Labour 11/21/2013 4
Case: Case A 34 year old female, with a known uterine septum, G5P4+0 came to the maternity ward at 34 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. 11/21/2013 5
Definition: Definition Obstructed labour is the failure of the fetus to descend through the birth canal, because there is an impossible barrier preventing its descent, despite strong uterine contractions. 11/21/2013 6
PowerPoint Presentation: 11/21/2013 7 Epidemiology KIUTH – Kampala International University Teaching Hospital
PowerPoint Presentation: 11/21/2013 8 Epidemiology KIUTH – Kampala International University Teaching Hospital
PowerPoint Presentation: Epidemiology 11/21/2013 9
PowerPoint Presentation: Epidemiology 11/21/2013 10
PowerPoint Presentation: Epidemiology 11/21/2013 11
PowerPoint Presentation: World wide Prevalence is 2-8% Maternal mortality rate is 8% Epidemiology 11/21/2013 12
Causes of obstructed labour: Causes of obstructed labour Powers 11/21/2013 13
PowerPoint Presentation: Causes of obstructed labour 11/21/2013 14
PowerPoint Presentation: Causes of obstructed labour 11/21/2013 15
PowerPoint Presentation: Causes of obstructed labour 11/21/2013 16
PowerPoint Presentation: Causes of obstructed labour 11/21/2013 17
PowerPoint Presentation: Causes of obstructed labour 11/21/2013 18
PowerPoint Presentation: Causes of obstructed labour 11/21/2013 19
Causes of obstructed labour: Powers Passenger Causes of obstructed labour 11/21/2013 20
PowerPoint Presentation: Hydrocephalus Causes of obstructed labour 11/21/2013 21
PowerPoint Presentation: Malposition Malpresentation Causes of obstructed labour 11/21/2013 22
PowerPoint Presentation: Shoulder Dystocia Causes of obstructed labour 11/21/2013 23
PowerPoint Presentation: Conjoined Twins Causes of obstructed labour 11/21/2013 24
PowerPoint Presentation: Conjoined Twins Causes of obstructed labour 11/21/2013 25
PowerPoint Presentation: Conjoined Twins Causes of obstructed labour 11/21/2013 26
Causes of obstructed labour: Powers Passenger Passage Causes of obstructed labour 11/21/2013 27
PowerPoint Presentation: Inadequate Pelvis Causes of obstructed labour 11/21/2013 28
PowerPoint Presentation: Umbilical Cord Prolase Causes of obstructed labour 11/21/2013 29
PowerPoint Presentation: Female Circumcision Causes of obstructed labour 11/21/2013 30
Clinical features: Prolonged labour Mother appears weak Abnormal vital signs 11/21/2013 31 Clinical features General examination
Clinical features: Malpresentation Bandl’s ring 11/21/2013 32 Clinical features Abdominal examination
Clinical features: Clinical features 11/21/2013 33 Abdominal examination Bandl’s ring
Clinical features: Foul smelling meconium Oedema of the vulva and cervix Caput on the fetal head 11/21/2013 34 Clinical features Vaginal examination
Differential diagnosis: Full bladder Fundal myoma 11/21/2013 35 Differential diagnosis
Investigations: 11/21/2013 36 Investigations Partograph
Investigations: Investigations CBC Serum electrolytes Sonography TAUS 11/21/2013 37 Blood Imaging
Management: Rehydration Catheterization Caesarean delivery 11/21/2013 38 Management
Complications: Fistula PPH Slow involution Shock Paralytic ileus Sepsis Death 11/21/2013 39 Complications Maternal
Complications: Neonatal sepsis Convulsions Facial injury Severe asphyxia Death 11/21/2013 40 Complications Fetal
Prevention: Skilled birth attendance Using the partograph Birth preparedness Nutritional education Delaying early marriage 11/21/2013 41 Prevention
Prognosis: The prognosis of subsequent pregnancies depends on the cause for obstructed labour. 11/21/2013 42 Prognosis