Obstructed labour

Views:
 
Category: Education
     
 

Presentation Description

Obstructed labour is when the presenting part of the fetus cannot progress into the birth canal, despite strong uterine contractions.

Comments

Presentation Transcript

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