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Top 10 Labor Room Complications

Labor Room Complications

The Labor period consists of three stages, an early phase that begins with the onset of contractions and the gradual effacement (thinning out) and dilation (opening) of the cervix, followed by an active phase in which the cervix begins to dilate more rapidly and contractions are longer, stronger, and closer together. The active phase ends with a “transition period” as the cervix fully dilates to 10 centimeters. The second stage begins once you are fully dilated and ends with the birth of your baby; this period is often referred to as the pushing stage. The third stage begins right after the birth of your baby and involves the separation and delivery of the placenta.

In this article you can learn about some of the common complications of labor that can occur, including fetal distress, excessive bleeding and placenta previa.

Nuchal Cord
Under this, the umbilical cord is wrapped around the baby’s neck.
A nuchal cord doesn’t necessarily mean the baby is in danger. Often the cord is wrapped around the baby’s body or arm and the doctor doesn’t even mention it because it didn’t cause any problems. On the other hand, if the cord is being squeezed enough to decrease blood flow to the fetus, the heart rate will dip briefly. If during contraction the baby’s heart rate doesn’t go back up afterward, its a sign that the cord may be too tight, and that could mean the baby is having problems.

Breech Position
In such a situation, the baby is positioned in the uterus head up, bottom down; sideways; or feet first. It’s also known as “malpresentation.” Some doctors and midwives say getting on all fours to elevate your hips above your heart, then lowering yourself onto your forearms, encourages the baby to turn. At 37 weeks to 38 weeks, some doctors try external version-turning the baby manually by applying pressure to the mother’s abdomen. If that doesn’t work or the baby flips back, the doctor can try again or schedule a C-section.

Placenta Previa
In this situation, the placenta is covering the cervix. It is found early in pregnancy and about 75 percent of the time by the end of pregnancy, the placenta will correct itself.But, If the placenta is covering the cervix at 36 weeks, a C-section will likely be scheduled. If the mother is bleeding vaginally, however, she should have a C-section immediately because there can be significant blood loss. It is a leading cause of antepartum haemorrhage (vaginal bleeding). It affects approximately 0.4-0.5% of all labors.

Perineal lacerations
The term refers to a tear in the perineum, the area between the vagina and anus. There are 3 degree of Parineal Laceration, First degree: 16 percent; second degree: 17 percent; third or fourth degree: 2.5 percent. It’s more common with a first baby. A first-degree tear is a minor one that usually requires few or no stitches and causes minimal pain. A second-degree tear involves the muscles underneath and requires stitches, which dissolve during the healing process. Third- and fourth-degree tears extend to the anal sphincter and are, fortunately, rare. This can possibly e prevented by perineal massage during the last month of pregnancy has been found to reduce the chances of perineal trauma during birth (that includes having an episiotomy), stitches from a tear or episiotomy and pain afterward, according to a review of research by The Cochrane Library. Having an overly large baby increases risk.

Meconium Aspiration
Meconium (a black, tarry substance in the baby’s intestines) is present in amniotic fluid the baby has inhaled. This can cause breathing complications.This is more common in babies a week or more overdue, meconium is passed in 10 percent of labors. Of these, between 1 percent and 6 percent of babies become ill from it. If meconium is spotted, your doctor or midwife should clear it from the baby’s nose and mouth at birth. In case the baby inhales it, she’ll go to intensive care.

Cephalopelvic disproportion
When a baby’s head is too large in relation to the maternal pelvis and unable to fit through it, a diagnosis of cephalopelvic disproportion (CPD) is made. According to the American College of Nurse Midwives, cephalopelvic disproportion occurs in 1 in 250 pregnancies.Causes of CPD may include, presence of a large baby, abnormal fetal positions. small or abnormally-shaped maternal pelvis. Most often, babies with cephalopelvic disproportion are delivered via C-section.

Excessive bleeding
An estimated 4% of women experience postpartum hemorrhage – the excessive loss of blood within 24 hours of delivery. On average, women lose 500 ml during the vaginal delivery of a single baby. During a C-section for a single baby, the average amount of blood lost is 1,000 ml. Approximately 4% of women will experience postpartum hemorrhage – excessive bleeding following the delivery of a baby.The most common cause of postpartum hemorrhage is uterine atony, in which the uterine contractions are too weak to provide adequate compression to the blood vessels at the site of where the now-expelled placenta was attached to the uterus.Maternal blood pressure, shock and death can result from postpartum hemorrhage.

Amniotic cavity issues
It is a state of too much or too little amniotic fluid or rupturing of the membranes that hold the amniotic fluid (aka your “water breaks”) before labor at or beyond 37 weeks. Excessive fluid is common and rarely causes problems during labor. But once your water breaks, there’s less of a cushion for the umbilical cord, which can allow it to become compressed. If this is suspected, your doctor or midwife may insert water into the amniotic cavity. If your water breaks before you start having contractions, they’ll likely begin within 24 hours. Most care providers will want to induce labor right away, however, to decrease the chance of infection reaching the baby.

Abnormal fetal heart rate or rhythm
This situaion arises when the fetal heart rate goes outside the “normal” range of 110 to 160 beats per minute or the rhythm is unusual. Your doctor or midwife will consider several factors, including the length and pattern of the abnormality and how close you are to delivery before deciding whether to let labor continue or perform a C-section. Lying on your back during labor increases the chances of abnormal fetal heart rate tracings.

Preterm Labor:
When the mother’s body is trying to deliver the baby before she has reached full-term (37 weeks), it is refered to as pre-term labor. There is a risk of delivering the baby too early when the contractions are closer, stronger, and longer. Can feel like menstrual cramping or a subtle backache. In serious situations, bed rest and medications are necessary to help the pregnancy go full-term.

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