Precipitated labour

Objectives

By the end of this session , the students should be

able to:
 Define precipitated labour
 List the causes
 State the characteristics
 Outline the complications
 Describe the prevention
 Describe the management
Definition

 This is when labour is completed in one hour.

 Generally Labour is rapid and intense.
Possible causes

 Multiparity/ Grand multiparae

 Large pelvis
 Small fetus
 Previous precipitated labour
 Over use of oxytocic drugs during induction
 Use of African herbs
 Hereditary
 unknown
 Characteristics
 Contractions are strong and frequent from the
onset of labour
 First and second stage of labour are rapid
 The mother is very distressed with the excessive
contractions
 Sometimes the woman is unaware of the
contractions and has does not experience pain
until the head is on the perineum.
Complications

 Perineal trauma occurs due to rapid distension of

the vagina and perineum.
 Lacerations of the cervix
 There could be a retained placenta due to
uterine muscles not retracting following delivery
of the baby.
 Post partum Haemorrhage may take place due to
undetected lacerations and insufficient time for
the uterine muscles to contract following delivery
of the baby.
Complications continued

 Delivery takes place in an unsafe environment

resulting in infection, injury to the baby and
psychological trauma to the mother.
 There could be rapid moulding in the neonate
resulting in intracranial damage.
 Fetal hypoxia as a result of the frequency and
strength of contractions which may cause birth
asphyxia.
 Brachial plexus injuries caused by rapid descent
and uncontrolled birth.
Prevention

 At antenatal booking and admission in labour

enquire about the length of previous labours and
where they were less than 6 hours then inform
the woman that his labour is likely to be shorter.
 Encourage all at risk women to go to hospital at
38 weeks and await delivery.
 Discourage use of traditional herbs during
pregnancy and labour.
Management
 Admit the woman to labour as fast as possible.
 Closely monitor the woman
 Delivery pack is kept at hand.
 Keep the emergency kit ready in case of PPH and birth
asphyxia
 Prepare for delivery quickly and be prepared for a Post
partum haemorrhage.
 Commence an IVI of Normal saline and have oxytocin
ready for management of third stage of labour after
delivery.
Management continued

 Deliver the woman in ‘All Fours’ position to slow

down the delivery of the baby.
 Encourage the woman not to push but to just
breathe out the baby.
 Carry out active management of third stage of
labour.
 Following delivery, palpate the uterus to ensure
that it is well contracted, assess blood loss, the
blood pressure and pulse every 5 minutes.
Management continued…..

 Prior to discharge check the haemoglobin

and give advice on family planning.
Nursing diagnoses

1. Risk for injury (maternal and fetal) related

to rapid labour and birth
2. Altered comfort, pain related to rapid labour
process
3. Anxiety (maternal) related to unknown
outcome of labour
Thank you