Labour and Delivery Management for UPSC CMS: Stages, Normal Labour and Complications

Stages of Labour#

First stage: Cervical dilatation (0-10cm). Latent phase (0-3cm, slow), Active phase (3-10cm, 1cm/hr). Duration: 8-12 hrs (primigravida), 5-8 hrs (multigravida).

Second stage: Full dilatation to delivery of baby. Duration: 1-2 hrs (primi), 30 min (multi).

Third stage: Delivery of baby to delivery of placenta. Active management: Oxytocin + controlled cord traction.

Partograph#

Records: Cervical dilatation (alert line at 4cm, action at 1cm/hr less), FHR, membranes, liquor, contractions, pulse, BP.

Complications#

Prolonged labour, obstructed labour, cord prolapse, shoulder dystocia, PPH (4Ts: Tone, Trauma, Tissue, Thrombin).