Labour Complications in Global Settings Flashcards
How can labour complications be context specific?
Place of birth, foetal/ maternal monitoring, access to medical care, CS, assisted vaginal birth and severity of female genital mutilation
What can prolonged labour lead to?
Uterine rupture, obstetric fistula and postpartum haemorrhage
What key labour complications can occur when healthcare resources are limited?
Prolonged labour
Untreated hypertensive disorders of pregnancy
Infection
Intrauterine death, preterm birth and neonatal death
What are the top maternal mortality causes in low income settings?
Postpartum haemorrhage
Infection post-birth
High blood pressure complications
What are context specific risk factors for adverse outcomes?
Education, socioeconomic status, intimate partner violence, cultural practices, long distance travel, multiparity, twin pregnancy and lack of women’s involvement
What is a uterine rupture?
Tear of the anterior uterine wall
Blood then flows into the abdomen
What are uterine rupture risk factors?
Prolonged labour
Previous uterine surgery
What is obstetric fistula?
During prolonged labour, compression of soft tissues between baby’s head and women’s pelvis cuts off blood flow to bladder and rectum - tissues dies which leaves a hole/ fistula
What is placenta accreta?
Placenta attaches firmly to uterine wall lining
What is the management for a fistula?
Repair - complex and can be provided from charity organisation
Requires extensive experience and surgical skills
What is placenta increta?
Placenta invades at least halfway through uterine wall
What is placenta percreta?
Invasion through uterine wall and sometimes into nearby tissues like the bladder
What are some preventions for labour complications?
Oxytocin injections, good hygiene, early treatment of infection and BP control
Magnesium sulphate in severe pre-eclampssia
