12/10/2023 0 Comments Complications of precipitate labor![]() 3, 5 Further, having one cesarean delivery increases the likelihood of having subsequent cesarean deliveries. However, there is a tradeoff, since cesarean delivery itself increases the risk of maternal hemorrhage, venous thromboembolism, and injury to the bladder and other internal organs, and can affect post-delivery mother–baby interactions. 4 Reducing the likelihood of these adverse maternal and neonatal outcomes is the underlying rationale for performing a cesarean delivery for the primary indication of labor dystocia. Prolonged labor may increase the risk for maternal and neonatal infection, fetal distress, neonatal hypoxia, uterine rupture, and postpartum hemorrhage it may also be a marker for increased risk of maternal pelvic floor and genital trauma during delivery (with a subsequent increased risk for future incontinence and pelvic organ prolapse). We also limit our review to women in spontaneous labor, with definitions varying somewhat between studies but generally including the onset of spontaneous uterine contractions, and explicitly exclude studies of women undergoing induction, or women with premature rupture of membranes at term in the absence of contractions. For the purposes of this systematic review, we assume that “labor dystocia” refers to “abnormal” labor progression during the latent (up to 4-6 cm dilation) or active phases (from 4-6 cm until full dilation) of the first stage of labor, or during the second stage (from complete cervical dilation until delivery of the baby), although, as discussed below, there have been substantial changes in practice since these “traditional” definitions were developed which raise questions about their generalizability to modern populations. “Labor dystocia” (difficult or obstructed labor) 2 encompasses a variety of concepts, ranging from “abnormally” slow dilation of the cervix or descent of the fetus during active labor 3 to entrapment of the fetal shoulders after delivery of the head (“shoulder dystocia,” an obstetric emergency). Approximately 80 percent of American women will eventually have at least one child, 1 and the majority of these women will undergo labor.
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