While the licensed maximum dose is currently 20 mU/min, some clinicians support the use of regimens up to 40 mU/min. The appropriate dose of syntocinon remains controversial, but there is good evidence for starting at a low dose, around 0.5–4 mU/min, and increasing over 4 or 5 h to 12 mU/min. The choice of dosage regimens for each represents a compromise between efficacy and the risk of hyperstimulation. Both syntocinon (synthetic oxytocin that is administered by injection or infusion) and prostaglandins may be implicated. Uterine hyperstimulation occurs much more commonly, however, and by definition is caused by the use of oxytocics. Spontaneous uterine hypercontractility may be associated with placental abruption (see p. The contractions may be excessively long in duration or be excessively frequent and there is a risk of fetal hypoxia due to interference with the placental blood supply. Spontaneous hypercontractility is rare, perhaps occurring in only 1:3000 pregnancies. It is subdivided into ‘true’ cephalopelvic disproportion if the head is in the correct position and ‘relative’ cephalopelvic disproportion if the obstruction is caused by the head presenting in a position other than occipitoanterior. Slow labour may result from inadequate uterine activity, cephalopelvic disproportion, or more commonly, a combination of the two.Ĭephalopelvic disproportion refers to how well the fetal head fits through the pelvis and may occur if the fetal head is too big or the pelvis too small. Precipitate labour has been defined as expulsion of the fetus within less than 3 h of the onset of contractions and results from uterine overactivity. In practice, overactivity presents as rapid painful contractions often associated with fetal distress, and inadequate uterine activity as absent or slow cervical dilatation. It is tempting to refer to uterine ‘overactivity’ as that which results in labour progressing too quickly, and ‘inadequate’ uterine activity as that which is insufficient to provide adequate progress, but the rate of progress has no precise definition either and is dependent on parity. It is important to remember that for many women who have a fast labour it is without complication.įrom FAQs to information about what happens during labour, you can discover all our Labour & Birth information here.Abnormal uterine activity has no clear definition, partly because the range of normal uterine activity itself has no clear definition. If you are currently pregnant and worried about having a precipitate labour then it can help to plan your route to hospital and be prepared with your hospital baby towards the end of pregnancy to take away any stress about getting to the maternity unit quickly. We always encourage women and their partners to access services that offer a chance to be able to talk about their birth, either via the maternity unit or with your midwife or health visitor. It can be quite overwhelming and difficult to process as everything happened so quickly. Your midwife will monitor you closely during the labour and after your baby has been born in case this happens.įor many women who have experienced a precipitate labour, they often find it useful to talk to a health professional about their birth experience. If a labour is happening very quickly there is also a slightly higher chance of bleeding heavier after the baby has been born, having perineal tears or the placenta being stuck inside your womb. It often comes with little warning or time to get used to what is happening. If a woman is experiencing a precipitate labour, it is usual to suddenly feel strong and powerful contractions straight away without the build-up of the irregular tightenings first. Whilst many pregnant women often hope for a quick labour, it can also be quite distressing and some women can feel a sense of being out of control of what is happening. Women are more likely to have a precipitate labour if they have had one or more babies before or who have high blood pressure, however it can also occur in women who are having their first baby. Precipitate labour is when a labour is very quick and short, and the baby is born less than 3 hours after the start of contractions. Hoping for a quick labour is common for many mums-to-be, but quicker isn’t always better.
0 Comments
Leave a Reply. |