Nursing Management and Prevention of Obstructed Labour

What is Obstructed Labor?

Obstructed labour is one where in spite of good uterine contraction; the progressive descent of the presenting part is arrested due to mechanical obstruction. It is a most dangerous condition. If it is untreated, it can be fatal to both mother and fetus.

Nursing management of obstructed labor
Fig: Nursing management of obstructed labor

Nursing Management of Obstructed Labor:

The underlying principles of management are-

  1. To relieve the obstruction at the earliest period by a safe procedure,
  2. To combat dehydration and keto –acidosis,
  3. To control sepsis.

A. Preliminaries:

  • The patient should be sedated by intra-muscular morphine 15mg.
  • Dehydration and keto acidosis are to be energetically corrected by rapid infusion of 5% dextrose at least one litre is to be given in running drip.
  • Acidosis is corrected by I.V administration of 100 ml 8.4%sodium bicarbonate and to be repeated.
  • Parenteral ampicillin 500 mg is administered and then repeated at intervals.
  • Blood sample is sent for grouping and cross matching.
  • A vaginal swab is taken and sent for C/S.

B. Obstetric management:

1. Vaginal delivery:

  • The baby is invariably dead in most of the neglected cases and destructive is the best choice to relieve the obstruction.
  • If the head is low m forceps extraction may be done in a living baby.
  • There is no place of interval version in obstructed labour.
  • After completion of the delivery and expulsion of the placenta, exploration of the uterus and the lower genital tract should be done to exclude uterine rupture or tear.

2. Caesarean section:

If the case is detected early with good foetal condition, Caesarean section gives good results.

Prevention of Obstructed Labour:

We can prevent obstructed labour in our country by following ways-

1. Antenatal prevention:

Intelligent anticipation of the cases likely to develop obstructed labour and appropriate management in an equipped hospital.

2. Intranatal prevention:

Continuous vigilance, use of partograph and timely intervention of a prolonged labour due to mechanical factors can prevent a case from proceeding to the stage of obstructed labour.

Pain Management During Labor:

By the below ways, pain can be managed during labour-

  1. Pharmacological technique by uses of medications.
  2. Non-Pharmacological techniques. These are –
  • Counter pressure,
  • Light massage,
  • Therapeutic touch,
  • Walking,
  • Rocking,
  • Application of heat & cold,
  • Water / hydrotherapy,
  • Aroma Therapy,
  • Breathing techniques- by slow chest breathing, shallow chest breathing, deep breathing etc.,
  • Music therapy,
  • Hypnosis therapy,
  • Provide emotional support by expressing care, being dependable, helping, advocacy, encouraging,
  • Positioning: Women who labour in upright positions during labour experience less pain.

More questions related to this article:

  1. What do you mean by obstructed labour?
  2. How will you manage obstructed labour in your hospital?
  3. A prime patient comes to you at 40 weeks of pregnancy with obstructed labour. How will you manage her?
  4. How to manage obstructed labour patient?
  5. How can you prevent obstructed labour in our country?
  6. How to manage pain during labour?
  7. What are the non-pharmacological pain relief methods?
  8. What are the techniques of relief pain?
  9. Mention some methods of pain relief during labour.

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