The labor and birth process is usually straightforward, but sometimes complications arise that may need immediate attention. Show Complications can occur during any part of the labor process. According to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, specialized help is more likely to be needed if a pregnancy lasts more than 42 weeks, if there has been a previous cesarean delivery, or when the mother is of an older age. This article will look at ten of the problems that can occur, why they happen, the treatment available, and some measures that can help prevent them. Share on PinterestIf delivery takes longer than expected, this may be described as “failure to progress.” This can happen for a number of reasons. Prolonged labor, labor that does not progress, or failure to progress is when labor lasts longer than expected. Studies suggest that this affects around 8 percent of those giving birth. It can happen for a number of reasons. The American Pregnancy Association define prolonged labor as lasting over 20 hours if it is a first delivery. For those who have previously given birth, failure to progress is when labor lasts more than 14 hours. If prolonged labor happens during the early, or latent, phase it can be tiring but does not usually lead to complications. However, if it happens during the active phase, medical assessment and intervention may be needed. Causes of prolonged labor include:
Pain medications can also contribute by slowing or weakening uterine contractions. If labor fails to progress, the first advice is to relax and wait. The American Pregnancy Association advise taking a walk, having a sleep, or running a warm bath. In the later stages, health professionals may give labor-inducing medications or recommend a cesarean delivery. “Non-reassuring fetal status,” previously known as fetal distress, is used to describe when a fetus does not appear to be doing well. The new term is recommended by the American College of Obstetricians and Gynecologists (ACOG), because “fetal distress” is not specific, and it may result in inaccurate treatment. Non-reassuring fetal status may be linked to:
Underlying causes and conditions can include:
It is more likely to occur in pregnancies that last 42 weeks or longer. Strategies that may help with during episodes of non-reassuring fetal status include:
In some cases, a cesarian delivery may be necessary. Perinatal asphyxia has been defined as “failing to initiate and sustain breathing at birth.” It can happen before, during or immediately after delivery, due to an inadequate supply of oxygen. It is a non-specific term that involves a complex range of problems. It can lead to:
Cardiovascular problems and organ malfunction can result. Before delivery, symptoms may include a low heart rate and low pH levels, indicating high acidity. At birth, there may be a low APGAR score of 0 to 3 for more than 5 minutes. Other indications may include:
Treatment of perinatal asphyxia can include providing oxygen to the mother, or carrying out a cesarean delivery. After delivery, mechanical breathing or medication may be necessary. Share on PinterestChanging position may help resolve shoulder dystocia.Shoulder dystocia is when the head is delivered vaginally but the shoulders remain inside the mother. It is not common, but it is more likely to affect women who have not given birth before, and is responsible for half of all cesarean deliveries in this group. Health providers may apply specific maneuvers to release the shoulders: These include:
An episiotomy, or surgical widening of the vagina, may be needed to make room for the shoulders. Complications are usually treatable and temporary. However, if a non-reassuring fetal heart rate is also present, this may indicate other problems. Possible problems include:
Maternal complications include uterine, vaginal, cervical or rectal tearing and heavy bleeding after delivery. On average, women lose 500 milliliters (ml) of blood during the vaginal delivery of a single baby. During a cesarian delivery for a single baby, the average amount of blood lost is 1,000 ml. It can occur within 24 hours after delivery or up to 12 weeks later, in the case of secondary bleeding. Around 80 percent of cases of postpartum hemorrhage result from a lack of uterine tone. Bleeding happens after the placenta is expelled, because the uterine contractions are too weak and cannot provide enough compression to the blood vessels at the site of where the placenta was attached to the uterus. Low blood pressure, organ failure, shock, and death can result. Certain medical conditions and treatments can increase the risk of developing postpartum hemorrhage:
Other medical conditions that can lead to a higher risk include:
Treatment aims to stop the bleeding as soon as possible. Options include:
Excessive bleeding can be life-threatening, but with rapid and appropriate medical help, the outlook is normally good. Share on PinterestA cesarian delivery, episiotomy, or forceps delivery may be necessary if the baby’s position is preventing the birth.Not all babies will be in the best position for vaginal delivery. Facing downward is the most common fetal birth position, but babies can be in other positions. They include:
Depending on the position of the baby and the situation, it may be necessary to:
Umbilical cord Problems with the umbilical cord include:
If it is wrapped around the neck, if it is compressed, or emerges before the baby does, medical help will probably be needed. When the placenta covers the opening of the cervix, this is referred to as placenta previa. A cesarian delivery is usually necessary. It affects around 1 in 200 pregnancies in the third trimester. It is most likely to occur in those who:
The main symptom is bleeding without pain during the third trimester. This can range from light to heavy. Other possible indications include:
Treatment is usually:
It can increase the risk of a condition known as placenta accreta, a potentially life-threatening condition in which the placenta becomes inseparable from the wall of the uterus. The doctor may recommend avoiding intercourse, limiting travel, and avoiding pelvic examinations. Cephalopelvic disproportion (CPD) is when a baby’s head is unable to fit through the mother’s pelvis. According to the American College of Nurse Midwives, cephalopelvic disproportion occurs in 1 in 250 pregnancies. This can happen if:
A cesarian delivery will normally be necessary. If someone has previously had a cesarian delivery, there is a small chance that the scar could open during future labor. If this happens, the baby may be at risk of oxygen deprivation and a cesarian delivery may be necessary. The mother may be at risk of excessive bleeding. Apart from a previous cesarean delivery, other possible risk factors include:
Women who plan for a vaginal birth after previously having a cesarian delivery should aim to deliver at a health care facility. This will provide access to facilities for a cesarean delivery and blood transfusion, should they be needed. Signs of a uterine rupture include:
Appropriate care and monitoring can reduce the risk of serious consequences. Together, the three stages of labor typically last for 6 to18 hours, but sometimes it lasts only 3 to 5 hours. This is known as rapid labor or precipitous labor. The chances of rapid labor are increased when:
Rapid labor can start with a sudden series of quick, intense contractions. This can leave little time in between for rest. They may resemble one continuous contraction. Disadvantages of rapid labor are that:
Risks for the baby include:
If there are signs of rapid labor starting, it is important to:
Lying down on the back or side may help. Complications during can be life-threatening in parts of the world where there is a lack of proper health care. Worldwide, 303,000 fatalities were expected to occur in 2015, according to the World Health Organization (WHO). In the U.S., the figure is around 700 each year. The main causes are:
Appropriate health care can prevent or resolve most of these problems. It is vital to attend all prenatal visits during pregnancy, and to follow the doctor’s advice and instructions regarding pregnancy and delivery. Which woman is most at risk for a uterine rupture quizlet?A woman who does not have at least 18 months between deliveries is at greater risk for uterine rupture.
When the uterine rupture occurs which of the following would be the priority?When uterine rupture occurs, which of the following would be the priority? Question 4 Explanation: With uterine rupture, the client is at risk for hypovolemic shock. Therefore, the priority is to prevent and limit hypovolemic shock.
What makes you high risk for preterm labor?These three risk factors make you most likely to have preterm labor and give birth early: You've had a premature baby in the past. You're pregnant with multiples (twins, triplets or more). You have problems with your uterus or cervix now or you've had them in the past.
What are 3 factors characteristics of effective uterine activity?Technically, effective uterine contractions include three factors: intensity, synchronization, and frequency of contractions.
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