Curriculum of Obstetrics
TOPIC 37
OBSTRUCTED LABOR
RATIONALE
Obstructed labor refers to cases in which spontaneous vaginal delivery is difficult or impossible due to insuperable mechanical obstacles. This should not be encountered in modern obstetric practice.
GOAL
Acquire the knowledge and skills to understand the causes, clinical picture, and treatment of obstructed labor, concentrating on avoidance of obstructed labor and rapid management
LEARNING OBJECTIVES
By the end of this course, the student will be able to:
l Define obstructed labor
l Enumerate the causes of obstruction in the passage, passenger, and/or the power
l Describe the clinical picture of early obstruction in the form of an abnormal pattern of labor
l Describe the clinical picture of late obstruction in the form of maternal and fetal distress and local signs manifesting themselves as impending rupture of the uterus
l Recognize that good observation is part of a prevention policy
l List the lines of management in early and late cases
l Be able to feel contractions with obstruction plus Bandls ring and round ligament
l Record signs of maternal and fetal distress
l Appreciate rapid intervention
l Be able to assess the progress of labor using the partograph
CONTENT
l Definition and incidence of obstructed labor
l Causes of obstructed labor
l Complications
l Methods of diagnosis
l Management, including preventive measures with stress on the importance of cesarean section
