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Chapter-43 Prolonged and Obstructed Labor

BOOK TITLE: Essentials of Obstetrics

Author
1. Ganguly Rajendra Prasad
2. Mukherji Joydev
3. Kamilya Gourisankar
ISBN
9788184489095
DOI
10.5005/jp/books/11242_43
Edition
2/e
Publishing Year
2011
Pages
9
Author Affiliations
1. RG Kar Medical College, Kolkata, RG kar Medical College, Kolkata, India, RG Kar Medical College, Kolkata, West Bengal, India
2. RG Kar Medical College, Kolkata, RG Kar Medical College Hospital, Kolkata, North Bengal Medical College, West Bengal, India, RG Kar Medical College, Kolkata, West Bengal, India, RG Kar Medical College, Kolkata, WB, India, RG Kar Medical College and Hospital, Kolkata, West Bengal, India, Kolkata, West Bengal, India, North Bengal Medical College, Siliguri, West Bengal, India
3. RG Kar Medical College, Kolkata, BS Medical College Hospital, Kolkata, India, Kolkata, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
Chapter keywords

Abstract

Prolonged and obstructed labors are important causes of maternal and perinatal morbidity and mortality in developing countries. An active first stage of labor lasting longer than 12 hours (roughly equivalent to a rate of dilation of 0.5 cm/hour) is commonly cited to be prolonged. Cephalopelvic disproportion, malpresentation and uterine inertia are common causes of prolonged labor. Labor is said to be obstructed when in spite of good uterine contractions, the progress of labor comes to a standstill due to mechanical factors causing obstruction to delivery. Obstructed labor may cause rupture uterus which is a cause of maternal mortality. The partograph is an invaluable tool to prevent prolonged labor and to time interventions optimally. When neglected patients come with prolonged labor, as in developing countries, they require urgent management at first referral level hospitals. Clinical examination is to identify the cause and to determine the condition of the mother and baby. After excluding obstruction, augmentation may be undertaken. Obstructed labor is a desperate emergency and in majority of cases the baby is dead and the mother moribund. Active resuscitation and operative delivery are required. Destructive operations may still have a role, albeit small, in developing countries.

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