| Obstetric labor complication | |
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| Specialty | Obstetrics  |
Anobstetric labor complication is a difficulty or abnormality that arises during the process ofchildbirth.
TheTrust for America's Health reports that as of 2011, about one third of American births have some complications; many are directly related to the mother's health including increasing rates ofobesity,type 2 diabetes, andphysical inactivity. The U.S.Centers for Disease Control and Prevention (CDC) has led an initiative to improve women's health previous to conception in an effort to improve bothneonatal and maternal death rates.[1]
Anamniotic fluid embolism (AFE) is a rare childbirth (obstetric) emergency in whichamniotic fluid enters the blood stream of the mother to trigger a serious reaction. This reaction then results in cardiorespiratory (heart and lung) collapse and massive bleeding (coagulopathy).[2][3][4]
Obstetrical bleeding is the leading cause of death in birthing mothers globally, especially in the developing world. Heavy blood loss may lead tohypovolemic shock, insufficientperfusion of vital organs and death if not rapidly treated. Blood transfusion may be life-saving. Causes of heavy bleeding during labour includeplacental abruption anduterine rupture.
Umbilical cord prolapse occurs when theumbilical cord comes out of theuterus with or before the presenting part of thefetus. Umbilical cord prolapse should always be considered a possibility when there is a sudden decrease infetal heart rate or variable decelerations, particularly after therupture of membranes. With overt prolapses, the diagnosis can be confirmed if the cord can be palpated on vaginal examination. Without overt prolapse, the diagnosis can only be confirmed after acesarean section, though even then it will not always be evident at time of procedure.[5]
The second stage of labour may be delayed or lengthy due to poor or uncoordinated uterine action, an abnormal uterine position such asbreech orshoulder dystocia, andcephalopelvic disproportion (a small pelvis or large infant). Prolonged labour may result in maternal exhaustion, fetal distress, and other complications includingobstetric fistula.[6]
Placental abruption is separation of theplacenta from the uterus. Treatment of placental abruption during labour is immediatedelivery if the fetus is mature (36 weeks or older), or if a younger fetus or the mother is in distress.[citation needed]
Premature labour is labour that spontaneously occurs earlier than 37 weeksgestational age.
A nuchal cord is a complication that occurs when theumbilical cord becomes wrapped around thefetal neck.
Perinatal asphyxia is a medical condition resulting fromdeprivation of oxygen to a newborn infant during labour. Hypoxic damage can occur to most of the infant's organs (heart,lungs,liver,gut,kidneys), butbrain damage is of most concern and the least likely to quickly or completely heal.[7] Treatment is immediate delivery (C-section). Causes of perinatal asphyxia includeumbilical cord prolapse,nuchal cord, andobstructed labour.
Risk factors for fetal birth injury includefetal macrosomia (big baby),maternal obesity, the need for instrumental delivery, and an inexperienced attendant. Specific situations that can contribute to birth injury include breech presentation,conduplicato corpore andshoulder dystocia. Most fetal birth injuries resolve without long term harm, butbrachial plexus injury may lead toErb's palsy orKlumpke's paralysis.[8]
A uterine rupture is a serious event duringchildbirth by which the integrity of themyometrial wall is breached. In an incomplete rupture, theperitoneum is still intact. With a complete rupture, the contents of the uterus may spill into theperitoneal cavity or thebroad ligament. A uterine rupture is a life-threatening event for both mother and baby as it typically results insevere hemorrhage and can causeperinatal asphyxia.
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