Obstructed labour
Obstructed labour | |
---|---|
Other names | Labour dystocia |
Frequency | 6.5 million (2015)[5] |
Deaths | 23,100 (2015)[6] |
Obstructed labour, also known as labour dystocia, is the baby not exiting the pelvis because it is physically blocked during
The main causes of obstructed labour include a large or abnormally positioned baby, a small
The treatment of obstructed labour may require
Cause
The main causes of obstructed labour include a large or abnormally positioned baby, a small
Evolution
Obstructed labor is more common in humans than any other species and continues to be a main cause of birth complications today.[12] Modern humans have morphologically evolved to survive as bipeds, however, bipedalism has resulted in skeletal changes that have consequently narrowed the pelvis and the birth canal.[13] The combination of increased brain size and changes in pelvic structure are the major contributors of obstructed labor in modern humans. It is also common for obstructed labor in humans to be caused by the fetus' broad shoulders. However, morphological shifts in pelvic structure still account for the inability of a fetus to effectively pass through the birth canal without major complications [14]
Other primates have a wider and straighter birth canal that allows a fetus to pass through more effectively.[15] Mismatch between birth canal size and infant cranial width and length due to bipedal locomotion requirements have often been referred to as the obstetric dilemma, since compared to other great apes, modern humans have the greatest disproportion between infant cranial size and birth canal size.[16] Shrinking of upper extremities and curvature of the spine have also affected the way modern humans give birth. Quadruped apes have longer upper limbs that allow them to reach down and pull their fetus out of the birth canal unassisted.[14] Other primates also have a wider and straighter birth canal that allows a fetus to pass through more effectively.[15] Modern human's shorter upper extremities and evolution of bipedal locomotion may have placed a premium on assistance during labor. For this reason, researchers argue that assisted labor may have evolved with bipedalism.[14] Obstructed labor has been documented as a complication of childbirth since the field of obstetrics originated. For over 1,000 years obstetricians have had to forcibly remove obstructed labor fetuses to prevent the death of the mother.[17]
Prior to the existence of the cesarean section, fetuses that were obstructed had a low survival rate.[17] Even in the 21st century, if obstructed labor is left untreated, it could result in mother and infant death.[16] Although surgical removal of the fetus is the preferred method of managing obstructed labor, manual removal using medical tools is also common.[15]
Diagnosis
Obstructed labour is usually diagnosed based on physical examination.[7] Ultrasound can be used to predict malpresentation of the fetus.[11] In examination of the cervix once labor has begun, all examinations are compared to regular cervical assessments. The comparison between the average cervical assessment and the current state of the mother allows for a diagnosis of obstructed labor.[1] An increasingly long time in labor also indicates a mechanical issue that is preventing the fetus from exiting the womb.[1]
Prevention
Access to proper health services can reduce the prevalence of obstructed labor.[11] Less developed areas have inadequate health services to attend to obstructed labor, resulting in a higher prevalence among less developed areas. Improving nutrition of female, both before and during pregnancy, is important for reducing the risk of obstructive labor.[11] Creating education programs about reproduction and increasing access to reproductive services such as contraception and family planning in developing areas can also reduce the prevalence of obstructed labor.[18]
Treatment
Before considering surgical options, changing the posture of the mother during labor can help to progress labor.
Prognosis
If
Epidemiology
In 2013 it resulted in 19,000 maternal deaths down from 29,000 deaths in 1990.[9] Globally, obstructed labor accounts for 8% of maternal deaths.[20]
Etymology
The word dystocia means 'difficult labour'.
Other terms for obstructed labour include difficult labour, abnormal labour, difficult childbirth, abnormal childbirth, and dysfunctional labour.[citation needed]
Other animals
The term can also be used in the context of various animals. Dystocia pertaining to birds and reptiles is also called egg binding.[citation needed]
In part due to extensive selective breeding, miniature horse mares experience dystocias more frequently than other breeds.[citation needed]
Most
-
Assisted delivery: miniature horse dystocia. Note the position of the head.
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Miniature horse dystocia. Note the position of the head.
References
- ^ PMID 14711764.
- ^ ISBN 978-92-4-154666-9. Archived(PDF) from the original on 2015-02-21.
- ^ ISBN 978-92-4-154666-9. Archived(PDF) from the original on 2015-02-21.
- ^ ISBN 978-92-4-154666-9. Archived(PDF) from the original on 2015-02-21.
- ^ PMID 27733282.
- ^ PMID 27733281.
- ^ ISBN 978-92-4-154666-9. Archived(PDF) from the original on 2015-02-21.
- ISBN 978-81-7179-826-1. Archivedfrom the original on 2016-03-04.
- ^ PMID 25530442.)
|Supplementary Appendix Page 190
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- S2CID 26968628.
- ^ PMID 10871595.
- PMID 14711750.
- PMID 4993117.
- ^ S2CID 35070435.
- ^ S2CID 24059450.
- ^ S2CID 9543264.
- ^ PMID 12151591.
- ^ S2CID 6981815.
- ^ Dolea C, AbouZahr C (July 2003). "Global burden of obstructed labour in the year 2000" (PDF). Evidence and Information for Policy (EIP), World Health Organization.
- S2CID 2190885.
- ^ Flintoff M (March 2024). "Babies on board: brachycephalic caesarean". The New Zealand Veterinary Nurse. 30 (109): 14–18.
- PMID 20136998.
Further reading
- Education material for teachers of midwifery : midwifery education modules (PDF) (2nd ed.). Geneva [Switzerland]: ISBN 978-92-4-154666-9.