Page 262 - Critical Maternity & Newborn Health Nursing

• Signs of dehydration: dry tongue and cracked lips.

Abdominal examination

• The uterus:

o is hard and tender,

o frequent strong uterine contractions with no relaxation in between

(tetanic contractions).

o rising retraction ring is seen and felt as an oblique groove across

the abdomen.
• The foetus:

o fetal parts cannot be felt easily.
o FHS are absent or show fetal distress due to interference with the

utero-placental blood flow.

Vaginal examination

• Vulva: is edematous.

• Vagina: is dry and hot.

• Cervix: is fully or partially dilated, oedematous and hanging.

• The membranes: are ruptured.

• The presenting part: is high and not engaged or impacted in
the pelvis. If it is the head it shows excessive moulding and large

caput.

• The cause of obstruction can be detected.

Complications of obstructed labor

Maternal:

1.Maternal distress and ketoacidosis.

261 Table of Contents