Written by : Dr.M.D.Mazumdar, MD
Labor is said to be prolonged when the combined duration of both the first stage and second stages of labor is more than 18 hours. It is more common in a first pregnancy and in women over the age of 35 years.
Any change in this position can cause prolongation in the duration in labor. A breech presentation in which the fetus is in the buttocks down position, a face presentation in which the fetus faces the mother's abdomen, or a deflexed position of the head in which the neck of the fetus is less flexed or even straight or extended can all cause prolonged labor.
Cephalopelvic Disproportion or CPD is said to occur when the diameter of the presenting part of the fetal head is larger then the size of the maternal pelvic passage or birth canal. In most pregnant women in labor, ligaments and joints tend to become more flexible, enabling them to relax more at the time of labor.
The baby's skull bones are also capable of overlapping each other normally to some extent, decreasing the size of the head ('moulding'). So, it is difficult to estimate by physical examination alone if CPD is actually present.
But if labor is unduly prolonged and no other cause is detected, a diagnosis of CPD can be made.
True CPD occurs only when the baby is very big, as in a diabetic mother or a physically very small-built mother, or if the mother has had a fractured pelvis at some time. Read more ...
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There are two main methods of monitoring the baby:
With the discovery of various drugs capable of accelerating labour, prolonged labour is a rarity nowadays.
Drugs like epidosin causes softening of tissues in the cervix. If the cervix fails to dilate in spite of adequate uterine contraction, epidosin or buscopan can be safely given to cause softening of the cervix.
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