Dysfunctional Labor Syndrome

Clinical Description

Labor not progressing according to expectation

Causes: Consider 3 P's:

• Passenger: macrosomia, malpresentation, malposition
• Power: inadequate contractions
• Passage: inadequate pelvis, rickets, pelvic deformities
• Cephalopelvic disproportion

Investigations

• If fetal macrosomia or malpresentation suspected, perform an ultrasound scan if available.

Treatment

NON-PHARMACOLOGICAL/PHARMACOLOGICAL

Treatment

• Explain findings to the mother
• Ensure adequate pain relief (PCM, pethidine) and hydration
• Consult senior or refer as soon as possible if at a health centre
• If contractions are inadequate, then augment labour (refer to O & G protocol and guidelines)
• If obstructed labour (caput ++, moulding>++, Cervix poorly applied, Bandls ring, maternal and fetal distress) then C/S (refer to C/S section)