Maternal distress

Definition:-
Maternal distress means maternal exhaustion i.e. the
strain and stress of labour have proved too much for
the mother.
Maternal distress is a condition of mental and
physical exhaustion of the women during labour
usually caused by prolonged labour characterized by
maternal dehydration, altered vitals signs,
kedoacidosis.
Causes.
1. Prolonged labour due to
a. Contracted pelvis
b. CPD
c. Malpresentation and malposition
d. Rigid cervix
e. Rigid pelvic floor
f. Inefficient and in-coordinated uterine action
2. Obstructed labour due to
a Malpresentation, malposition , congenital abnormalities.
b Compound presentation
c CPD, locked twins etc.
3 Insufficient uterine contraction eg. hypotonic,
hypertonic, in-coordinate uterine action
4 Maternal bearing down from first stage
 Sign and symptoms
Increase the pulse rate is one of the earliest sign of
distress and it may be 120 or more per minutes .
Raise in temperature.
Anxious expression with ill looking and worried.
Mark restlessness ,weakness and sweating .
Severe dehydration , dry lip , dry and coated tongue ,
presence of acetone in the breath and urine.
Abdominal distension.
 vomiting
Increase in respiratory rate about 24-26/min.
Women may die if not manage properly and promptly
 Management of maternal Distress
Adequate rest , sedation ,dehydration and avoidance
of prolonged labour of are preventive measure
against maternal distress.
Keep continuous monitoring of fetal heart rate and
uterine activity.
 Observe maternal vital signs.
 Encourage to void periodically
 Provide and encourage to take plenty of fluids
regularly.
 Provide reassurance and emotional support to the
mother.
Inform to obstetrician immediately when the
sign of maternal distress are seen.

 Give IV infusion of 5-10% dextrose and R/L to

correct dehydration and ketoacidosis.

 Labour is terminated if the patient is exhausted

and the method employed depends on the
degree of cervical dilatation.
In the first stage of labour this will necessitate LS.
In second stage of labour, if the head is in the
perineum given episiotomy to hasten delivery or
forceps delivery can be done.
If head is high, delivery by vccum extraction.
Inform and make available pediatrician during
delivery.
 Provide complete rest to mother offer delivery.
“Pediatrician and resuscitations set should be
made available”.
 Dangers of maternal distress

PPH
Shock
Intrauterine and urinary infection
Maternal death
Fetal distress
Fetal death