The labour is said to be prolonged when the combined duration of 1st and 2nd stage is more than arbitrary time limit of 18 hours.
Prolongation may be due to failure to dilatation of cervix and/or inadequate descent of the presenting part during the 1st or 2nd stage of labour.
Normal duration of latent phase is about 8 hours in a primipara and 4 hours in a multipara
When the latent phase that exceeds 20 hours in primipara and 14 hours in multipara is abnormal. What is Latent phase of labour ?
Latent phase is the preparatory phase of the uterus and the cervix before the actual onset of labour.
Normally, this is the time of preparation for uterus and cervix for labour.
In more than 50% of cases the cause of preterm onset of labour is not known. The following are related with increased incidence of preterm labour :
A. History -
Previous history of induced or spontaneous abortion or preterm delivery.
Asymptomatic bacteriuria or recurrent urinary tract infection.
Baby's Development - In this week baby is now covered with a white, waxy substance called vernix caseosa, which helps prevent delicate skin from becoming chapped or scratched. Premature babies may be covered in this cheesy coating at delivery. Baby is still tiny, but this week brings the development of brown fat, which will help keep baby warm after birth. During the last trimester, baby will add more layers of fat for warmth and protection. Woman's Body - Woman feels baby's movements, which often happens between weeks 18 and 20. These first movements are known as quickening, and they may feel like butterflies in stomach or a growling stomach. Later in pregnancy, woman will feel kicks, punches, and possibly hiccups. Each baby has different movement patterns. Many women wonder around this time whether having sex. Sex is considered safe at all stages of pregnancy, as long as pregnancy is normal. But that doesn't necessarily mean woman are going to want to have it. Many expectant women find that their desire for sex fluctuates during the various stages of pregnancy, depending on their fatigue, growing size, anxiousness over the birth, and a host of other body changes. Related Articles :
Preterm labour is one where the labour starts before the 37th completed week (<259 days), counting from the first day of the last menstrual period. Preterm labour is also called premature labour. It starts more than three weeks before estimated date of delivery.
All clients should be offered voluntary serologic testing for HIV infection.
In seropositive cases additional investigation should be done to test for other STD's.
Husband should be offered serological test for HIV.
Counselling about the risk of HIV transmission to the fetus and neonates should be made and termination of pregnancy offered.
Progressive of the disease is assessed by CD-4, T-lymphocyte count and HIV RNA.
Assessment is done at every 3-4 months internal.
Care during intrapartum period -
Zidovudine is given IV infusion starting at the onset of labour (vaginal delivery) or 4 hours before caesarean section.
Mechanical suctioning devices should be used to remove secretions from the neonates airways.
Health care workers should be protected from contact with potentially infected body fluids.
Disposable syringes and needles are used and they are deposited in the puncture proof containers.
Postpartum care -
Mother must be counselled about risk and benefits of breast feeding and helped to make an informed choice.
Zidovudine syrup 2 mg/kg is given to the neonates four time daily for first 6 weeks.
Mother should be encouraged to manage the babies care herself with the support of midwife.
Glove must be worn for examination the perineum, lochia and caesarean wound.
Disposal of sanitary napkin and disinfection and cleaning of any spilled blood must be done correctly.
Contraceptive method -
Barrier method of contraception (condom or female condom) is effective in preventing transmission of virus. Thus the disease could be prevented predominantly by health education and by practice of safer sex. Related Articles :
HIV causes an incurable infection that leads ultimately to a terminal disease called AIDS which is a group retrovirus. Worldwide 25 - 30% of infected patients are woman and 90% of them are 22 - 49 of age.
Incidence -
Estimate at national level are that about 3.7 million people were suffering from HIV infection in most Asian countries. The infection rate is less than 0.5%.
Mode of transmission -
The mode of transmission of HIV are :
Sexual contact.
Exposure to infected blood or tissue fluid.
Through breast milk.
HIV infection in pregnancy -
The transmission from mother to fetus is about 30% in seropositive mothers. The fetus may be affected through uteroplacental transfer during delivery by contaminated secretion and blood of the birth canal and through breast milk in the neonatal period.