Maternal Complications in Labor

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Most maternal injuries occur during the second stage of labour but the diagnosis is made in the third stage after the delivery of the baby.

Although many of the maternal complications in labor can be avoided by proper management of labor and delivery, complications can occur in the best of hands and in the best of institutions.

Complications may be short term or immediate complications. Or they may appear some time after childbirth. These are called long term complications.

While there are a large number of potential maternal complications in labor, only the more common ones are described here.

Also, the maternal complications after a normal childbirth and after a cesarian section are different. Here, only complications after normal delivery have been described.

Immediate or Short Term Maternal Complications

These complications occur immediately after or even during the childbirth. In all cases of childbirth, a proper examination of the vulva and vagina is necessary to rule out any complications which may be missed at that time and become apparent at a later time. Early diagnosis prevents the complication from becoming more serious and from affecting the mother's health.

  • Vulvar Hematoma

    Although vulvar haematomas can also occur after an injury due to any cause, it is more commonly seen after the vaginal delivery of a baby. A Vulvar hematoma can occur either spontaneously or after improper repair of an episiotomy wound. Blood from a rupture of the deep veins of this region collects in a closed space with no opening for it to drain out. Read more ...

  • Perineal Tears

    The perineum may get injured when there is overstretching or rapid stretching of the perineum during the delivery of the baby. An inelastic perineum due to the presence of a scar can also lead to a perineal tear. Tears may be complete or incomplete. Read more ...

  • Vaginal Tears

    Vaginal Tears can occur at any part of the vaginal wall, but are seen mostly at the junction between the lateral and posterior walls. These tears may be superficial with only minor lacerations of the vaginal mucosa. But, sometimes the tears may be deep enough to expose the inner muscles. Read more ...

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  • Cervical Tears

    Cervical tears are quite common after childbirth. These are usually quite minor and heal spontaneously without any surgical intervention. But some tears may be quite deep and extend through the full length and thickness of the cervix. Read more ...

  • Periurethral Tears

    Periurethral tears are tears which occur at the region around the urethra - the opening through which urine comes out. The problem with these type of tears is that there may be profuse bleeding from even a small tear since the region has a large blood supply. Read more ...

  • Inversion of the Uterus

    This is a potentially life-threatening complication. In this condition, the placenta fails to detach from the uterine wall. It comes out of the uterus dragging the uterine wall along with it causing the uterus to be inversed (turn inside out).

  • Postpartum Bleeding

    Primary postpartum hemorrhage is defined as bleeding that occurs within 24 hours of the birth of the baby. This is again divided into two types: A. Third Stage hemorrhage. B. True Primary postpartum hemorhage. Read More ...

  • Rupture of the Uterus

    A uterine rupture can occur in women who have a normal vaginal childbirth after a cesarian section. It can occur either during late pregnancy or during childbirth. The strong uterine contractions during childbirth can cause a weak or unhealthy scar from the previous cesarian section to rupture.

Long Term Maternal Complications

These are complications which occur months or even years after the childbirth but are related to problems associated with childbirth.

  • Prolapse of the Uterus: Prolapse or descent of the uterus may or may not be related to childbirth. But the risks of a uterine prolapse in a women who has had a traumatic childbirth or of a woman who has had multiple childbirths are much more than in women who have never given birth. It is very rare for a woman to suffer a uterine prolapse without a normal vaginal childbirth.

  • Incontinence of Stool or Urine: Incontinence of stool or urine can occur after childbirth due to deep tears in the vaginal walls which go unnoticed at that time. These tears can become infected and the tissues between the rectum and vagina or the bladder /urethra and vagina can break down to cause fecal or urinary incontinence. Direct damage to the anal or bladder sphincter can also occur during a vaginal birth.

  • Sexual Dysfunction: Perineal scars and scars from other tears can cause pain during sexual intercourse. Pain is a common cause of sexual dysfunction. A loose vagina or weakened pelvic muscles may decrease sexual enjoyment in some women.

Most maternal complications, both immediate and long term, can be prevented if proper care is taken during childbirth..

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