OBSTRUCTED LABOUR.

FAULT IN THE PASSAGE. FAULT IN THE PASSENGER. ETIOLOGY. FAULT IN THE PASSAGE. FAULT IN THE PASSENGER.

Bony obstruction. Soft tissue obstruction. FAULT IN THE PASSAGE. Bony obstruction. Soft tissue obstruction.

BONY e.g. Contracted pelvis

e.g.Cephalopelvic disproportion

SOFT TISSUE OBSTRUCTION e.g.Cervical dystocia:

e.g.Cervical or broad ligament fibroid

e.g. Impacted ovarian tumor

e.g.Non gravid horn of a bicornuate uterus:

FAULT IN THE PASSENGER . Transverse lie. Brow presentation. Congenital malformations. Big baby. Occipito posterior positions. Compound presentation. Locked twins.

Transverse lie

Brow presentation

Congenital malformations

Big baby

Occipito posterior positions.

Compound presentation

Locked twins

Fetal Ascitis

MORBID ANATOMICAL CHANGES BLADDER UTERUS

Formation of bandl’s ring UTERUS: Formation of bandl’s ring

BLADDER: Bladder become an abdominal organ. Patient fails to empty the bladder. Bladder walls get traumatized. Blood stained urine. Pressure necrosis. Genito urinary fistula.

Genito urinary Fistula

SIGNS OF OBSTRUCTED LABOUR. EARLY SIGNS: PRESENTING PART DOES NOT ENTER THE PELVIC BRIM. SLOW CERVICAL DILATATION. LOOSELY HANGING CERVIX. EARLY RUPTURE OF MEMBRANE OR FORMATION OF A LARGE ELONGATED SAC OF FORE WATERS.

LATE SIGNS: MOTHER MAY BE DEHYDRATED AND KETOTIC AND IN CONSTANT PAIN. CLINICAL SIGNS:- PYREXIA, TACHYCARDIA. DIFFICULT ABDOMINAL PALPATION. DIFFICULT ABDOMINAL EXAMINATION. COMPLICATED VAGINAL EXAMINATION.

CONTI… LESS URINE OUTPUT,HAEMATURIA. EVIDENCE OF FETAL DISTRESS. PHYSIOLOGIC RETRACTION RING. VISIBLE RETRACTION RING OR BANDL’S RING. HOT,DRY VAGINA. PRESENTING PART WILL BE HIGH AND IMMOVABLE.