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Prolonged Labour
1. Definition
When the combined duration of the first and second stage of labour is more than the arbitrary time limit of 18 hours, it is termed prolonged labor. 3. Causes of Prolong Labor The prolongation encompasses delayed dilatation of the cervix (in the first stage) and/or inadequate Any one or combination of the basic elements descent of the presenting part (during the first or involved in labor are responsible, both in the First second stage).1 Stage - failure to dilate the cervix and the Second Stage - Sluggish or non-descent of the foetus in the Labor that lasts more than 24 hours is by definition second stage is due to called prolonged labor. The exact time of the onset of labor is often hard to diagnose. The best Fault in power include Inability to bear down, definition of the onset of labor is the time at which abnormal uterine contraction or in-coordinate the woman has contractions that lead toward the uterine contraction. birth of her baby. 2 Fault in the passage includes - contracted pelvis, pelvic tumor, eg:fibroid or even full Prolonged labour is most often defined as onset baldder. of regular, rhythmical painful contractions Fault in the passenger includes - malposition accompanied by cervical dilation where labour is and malpresentation, congenital anomalies of longer than 24 hours. This definition however has the foetus (hydrocephalus - common) Too limitations, and therefore it is more useful in terms often deflexed head, minor degrees of pelvic of management to refer to prolonged stage of contraction and disordered uterine action have labour, i.e. prolonged latent phase of labour or got sinister effects in causing non-dilatation of prolonged active phase of labour. Latent phase the cervix. being the onset of regular painful contractions with Others - Injudicious early administration of cervical dilation up to 4 cm, and should not be sedatives and analgesics before the actual longer than 8 hours. Prolonged active phase is, active labor begins. 1 regular painful contractions with cervical dilation of more than 4 cm should not last longer than 12 hours without full assessment in a facility able to offer management and treatment of complications.3
The position of the baby and the presenting part must be accurately diagnosed. Engagement and station should be noted. If there is failure of descent, the cause needs to be determined. Is it the cervix, the pelvis, the fetus, the size of the head, weak uterine contractions, etc.? The uterine contractions are assessed for strength, efficiency, frequency, length, interval, and changes. Pelvic adequacy and signs of CPD are assessed.
6. Assessment of Labor
The woman's progress is monitored and assessed regularly. The woman's general condition is observed for signs of fatigue: hydration, energy, nourishment, temperature, pulse.