Delay in progress in labour

Question 1

Delay in progress in labor.

Definition

Answer 1

failure of labor to progress occurring when labor lasts for more than ≥20 or ≥16 (nulliparous and multiparous respectively).

Nowadays, relies more on the rate of progression rather than absolute times.

Question 2

Delay in progress in labor

Features

Answer 2

90% of primigravid women deliver within 16 hours

• 90% of multigravida women deliver within 12 hours

• Labor that lasts more than 24 hours is rare these days

Question 3

Causes delay progress in labor

Answer 3

1. Power - uterine insufficient contraction
2. Passage – pelvis abnormality, fracture, uterine anomaly, cervical stenosis
3. Passenger – macrosomia, malpresentation

Question 4

Delay progress in labor Complications

Answer 4

1. Fetal distress
2. Infection
3. Birth canal damage
4. Intracerebral hemorrhage
5. Cord prolapse

Question 5

Management Delay progress in labor

Answer 5

1. Fetal and maternal monitoring
2. Let the mother stand up and walk around
3. Labor induction (if cephalopelvic disproportions has been excluded)
4. Cessation of medication that might cause this (analgesics).
5. Manual intervention Cephalopelvic disproportions (CPD) takes to mined the fetal and maternal parameters

a. Assisted vaginal delivery – usually in the early (latent) phase and when it is proven as safe for the mother and fetus.

b. C-section – usually in the active phase and immediately in cases of fetal distress, uterine rupture or cord prolapse.