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Obstructed labour

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

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Labour is obstructed when there is no advance of the presenting part despite strong uterine contractions. The obstruction usually occurs at the pelvic brim but may occur at the outlet.

Causes

  • Cephalopelvic disproportion
  • Deep transverse arrest
  • Malpresentation (e.g. shoulder or brow presentation or in persistent mentoposterior position
  • Pelvic mass (e.g. fibroids, ovarian or pelvic tumours)
  • Fetal abnormalities

If obstructed labour is recognised in the first stage of labour, delivery should be by caesarean section.

Further reading

World Health Organization, Managing prolonged and obstructed labour. Midwifery education module 3. http://www.who.int/maternal_child_adolescent/documents/3_9241546662/en/

Royal College of Obstetricians & Gynaecologists (2012). Shoulder dystocia (Green-top guideline No 42). https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg42/

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