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An obstetric labor complication is a difficulty or abnormality that arises during the process of labor or delivery.. The Trust for America's Health reports that as of 2011, about one third of American births have some complications; many are directly related to the mother's health including increasing rates of obesity, type 2 diabetes, and physical inactivity.
The second stage of labour may be delayed or lengthy due to poor or uncoordinated uterine action, an abnormal uterine position such as breech or shoulder dystocia, and cephalopelvic disproportion (a small pelvis or large infant).
In 2015 about 6.5 million cases of obstructed labour or uterine rupture occurred. [5] This resulted in 23,000 maternal deaths down from 29,000 deaths in 1990 (about 8% of all deaths related to pregnancy). [2] [6] [9] It is also one of the leading causes of stillbirth. [10] Most deaths due to this condition occur in the developing world. [1]
Uterine Tachysystole is a condition of excessively frequent uterine contractions during pregnancy. [1] It is most often seen in induced or augmented labor , though it can also occur during spontaneous labor , [ 2 ] and this may result in fetal hypoxia and acidosis .
In cases of uterine atony and corresponding blood loss, methergine or misoprostol can be given to encourage uterine contraction and achieve hemostasis. [5] Patients who have recently undergone an intact D&E are monitored for signs of coagulopathy, uterine perforation, uterine atony, retained tissue, or hemorrhage. [4]
The decrease in the coordination of uterine smooth muscles cells reduces the effectiveness of contractions, causing the uterus to enter a state of uterine quiescence. [8] During the beginning of labour, contractions may initially be intermittent and irregular, [ 7 ] but will transition into a more coordinated pattern as the labour progresses. [ 7 ]
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Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.