Definition of Obstructed Labour:
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 can be fatal to both mother and fetus.
Causes of Obstructed Labour:
A. Maternal factors:
1. Contraction or deformity of the bony pelvis.
2. Pelvic tumors:
- Uterine fibroids,
- Ovarian tumors,
- Tumors of rectum bladder or pelvic bones,
- Pelvic kidney.
3. Abnormalities of uterus or vagina
- Stenosis of the cervix or vagina,
- Obstructions by one horn of double uterus,
- Contraction ring of uterus.
B. Fetal factors:
1. Large fetus
2. Malpasition or malpresentation
- Presistent occipito-posterior or transerse position,
- Mento-posterior position,
- Brow presentation,
- Breach presentation,
- Shoulder presentation,
- Compound presentation,
- Locked twins.
Clinical Features of Obstructed Labour:
General condition:
- Labour pain becomes severe and prolonged
- Pt. looks tired anxious and behaves such that she is beginning loose her ability and will not co-operate.
- General condition of the pt. showS rise of pulse rate and temperature high colored urine and presence of ketone bodies in the urine.
- Partogram shows no progress of labour.
Clinical Features:
1. Probably the earliest sign of impending obstruction is deterioration in the pts general condition.
2. She looks tired and anxious and behaves as though she is beginning to look her ability and Will not co-operative. Between the contractions she seems unable to and her anxiety increases.
3. The membranes rupture early in labour because the presenting part is badly applied the lower segment. The amniotic fluid drains away and there is retraction of the placental site.
4. Pulse rate and temp rise
5. Quantity of urine diminishes and it is concentrated and deeply colored.
6. Ketone bodies are present in the urine and can also be smelt in patient’s breath.
7. Abdominal palpation reveals-
- Upper segment is hard, uniformly convex and tender. Lower segment is distended and tender.
- The pathological retraction ring is placed obliquely between the umbilicus and symphysis pubis and rises upwards in courses of time.
- Taut, tender round ligaments may be felt on either side.
- Foetal parts may not be well defined.
- FHS is usually absent.
8. On vaginal examination –
- Vagina is found to oedematous and feels dry the discharge is offensive,
- Cervix fully dilated,
- Membranes are absent,
- Cause of obstructed labor revealed.
Investigations of Obstructed Labour:
- USG: Previous USG may provide a clue about the cause of obstructed labor.
- Blood: Hb%, TC, DC.
- Blood grouping and Rh typing.
Complications of Obstructed Labour:
1. Effects on mother:
- Exhaustion is due to a constant agonizing pain and anxiety.
- Dehydration due to increased muscular activity without adequate fluid intake.
- Genital sepsis.
- Metabolic acidosis.
- Postpartum haemorrage and shock.
2. Effects on fetus:
- Asphyxia,
- Acidosis,
- Intra-cranial haemorrahage,
- Infection.
Four immediate complications of obstructed labor:
- PPH,
- Rupture of the uterus,
- Dehydration,
- Genital sepsis.
More questions related to this article:
- What do you mean by obstructed labour?
- What are main causes of obstructed labor?
- What are the sign and symptoms of obstructed labour?
- What are the investigations of obstructed labor?
- What are the four immediate complications of obstructed labour?
- What are the consequences of obstructed labor?
- What are the effects of obstructed labour?
- What are consequence of obstructed labor on foetus and mother?
Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “[email protected]”
