Labour is a physiological process characterized by regular uterine contractions leading to cervical dilation and delivery of the fetus. Proper management involves monitoring maternal and fetal well-being 👩‍🍼👶 and addressing potential complications promptly.
Labour management is divided into three stages, each requiring different interventions.

1️⃣ First Stage of Labour

Begins with regular contractions and ends at full cervical dilation (10 cm).
Subdivisions:
- 🌙 Latent phase: Slow dilation up to 4–6 cm, mild/irregular contractions.
- ☀️ Active phase: Rapid dilation 6–10 cm, strong contractions (1–1.5 cm/hr primigravida, faster in multiparas).
🛠️ Management:
- 📊 Monitor maternal vitals (BP, HR, temperature).
- 🎧 Continuous fetal heart monitoring (Doppler/CTG).
- 💊 Pain relief: breathing, hydrotherapy, opioids, gas & air, epidural/spinal.
- ✋ Periodic vaginal exams to assess progress.

2️⃣ Second Stage of Labour

From full dilation to delivery of the baby 👶.
May last minutes to hours; shorter in multiparas.
🛠️ Management:
- Encourage pushing with contractions.
- 🎧 Continue fetal heart monitoring.
- 🧍 Support maternal positioning (upright, lateral, lithotomy).
- ✂️ Episiotomy if required.
- 🛠️ Assisted delivery (vacuum/forceps) if prolonged or fetal distress.

3️⃣ Third Stage of Labour

From baby’s delivery to expulsion of placenta 🌿.
🛠️ Management:
- 💉 Uterotonic (e.g., oxytocin 10 IU IM) after anterior shoulder.
- 🤲 Controlled cord traction with counterpressure.
- 🔎 Look for signs of placental separation (cord lengthening, blood loss).
- 🧩 Inspect placenta for completeness to prevent retained products.

⚠️ Complications of Labour

🚨 Complication	📝 Description	🛠️ Management
⏳ Prolonged Labour	>20 hrs in primigravida or >14 hrs in multipara, often weak contractions or malposition.	💉 Oxytocin augmentation. 🛠️ Assisted delivery or Cesarean if no progress.
💔 Fetal Distress	Abnormal FHR, meconium, hypoxia risk.	🎧 Continuous FHR monitoring. 💧 Oxygen & IV fluids to mother. 🚨 Emergency Cesarean if unresolved.
🤱 Shoulder Dystocia	Shoulders stuck after head, often macrosomia.	🧎 McRoberts manoeuvre. 🤲 Suprapubic pressure. ✂️ Episiotomy ± operative delivery.
🩸 Postpartum Haemorrhage (PPH)	Bleeding >500 mL (vaginal) or >1000 mL (CS). Causes: atony, retained placenta, trauma.	💉 Uterotonics (oxytocin, misoprostol). 🤲 Uterine massage. 🔪 Surgical options: artery ligation, hysterectomy.
🪢 Umbilical Cord Prolapse	Cord ahead of baby → compression, hypoxia.	🚨 Immediate Cesarean. 🙆 Knee-chest position. ✋ Elevate presenting part manually.
💥 Uterine Rupture	Scar rupture → catastrophic maternal & fetal risk.	🚨 Immediate Cesarean. 💉 IV fluids, transfusion. 🔪 Emergency laparotomy ± hysterectomy.
🔄 Breech Presentation	Buttocks/feet first instead of head.	👐 External cephalic version. 🚨 Cesarean if unsuccessful/unsafe.
🌊 Amniotic Fluid Embolism	Rare, fatal: AF enters maternal blood → shock, DIC.	🫁 Oxygen & airway support. 💉 Fluids, transfusion, correction of clotting. 🤖 Intubation & ventilation.
⚖️ Cephalopelvic Disproportion (CPD)	Baby’s head too large for pelvis → obstructed labour.	📅 Elective Cesarean if diagnosed early. 🚨 Emergency Cesarean if detected intrapartum.

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Labour and Complications

🤰 Management of Labour and Complications

1️⃣ First Stage of Labour

2️⃣ Second Stage of Labour

3️⃣ Third Stage of Labour

⚠️ Complications of Labour

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