Possible complications during labor

Article by Master, Doctor Vu Thi Hong Chinh - Obstetrics Department - Vinmec Times City International General Hospital.

Any woman is at risk of facing complications, obstetric complications, obstetric complications that can occur at any time of pregnancy: During pregnancy, during labor and after 6 weeks postpartum. In which, complications and accidents occurring during labor account for the highest rate and are especially dangerous, causing high mortality rate for mother and fetus.

There are many complications and complications that can occur during labor, but there are 5 common complications and complications:

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Complications of bleeding can occur during labor or after birth. It is the most common obstetric complication and the leading cause of maternal death. Pregnant women can bleed during labor due to the following reasons:
Placenta placenta: Is the placenta partially or completely attached to the lower uterine segment and cervix causing bleeding in the last 3 months of pregnancy. , in labor and postpartum, most commonly in labor.
Placenta placenta can cause death or disease in the mother and baby due to bleeding and premature delivery.
Up to now, medicine has not fully studied the cause of placenta previa, but it has been found that the frequency of placenta previa increases in people with the following history:
History of placenta previa. History of cesarean section, hysterectomy for causes: uterine fibroids, hysterectomy. History of curettage, suction, multiple miscarriages, multiple births...

Prophylaxis: Good pregnancy management, early detection of placenta previa for proper prevention and management (monitoring at the hospital when the pregnancy is near term, active caesarean section when the pregnancy is full term).
Need to prepare a team of surgeons and anesthesiologists for resuscitation, blood backup and resuscitation facilities.
Placental abruption: A condition in which the placenta attaches properly to its normal position but prematurely peels off before delivery due to disease or trauma. The hematoma after the placenta grows larger, causing the placenta to detach from the wall of the uterus, cutting off the nourishment between the mother and the fetus, causing the death of the fetus and threatening the mother's life due to blood loss and coagulopathy. blood .
Cause: Due to trauma to the abdomen, mother's disease: preeclampsia,... Prevention: Good pregnancy management, detection and treatment of high-risk pregnancies Close follow-up labor to detect and treat complications promptly.

Uterine rupture: The rupture of all layers of the uterus, usually non-operatively, often accompanied by bleeding, possibly expulsion of part or all of the fetus into the abdomen.
Causes: Old incision in uterus, fetal and pelvic asymmetry, abnormal fetal position, intense contractions, use of tocolytic drugs not in accordance with indications and dosages, surgical intervention, non-procedural procedures Correct indications, techniques... Prevention: Good pregnancy management, detection of pregnancies with high risk of uterine rupture such as multiple births, incision in the uterus, fetal asymmetry- pelvis,... Closely monitor the labor, detect signs of threatened uterine rupture for timely treatment. Use the drug to increase uterine contractions exactly as indicated and dosage and carefully monitored. Perform obstetric surgery and procedures in accordance with indications, conditions and techniques.

Postpartum bleeding is bleeding right after giving birth, the amount of blood loss is more than 500ml or has an adverse effect on the mother's general condition.
Cause: Due to uterine atony, genital tract trauma, abnormality of placental abruption, placental abruption, blood clotting disorder.
Prevention:
Good pregnancy management, detect pregnancy cases with high risk of postpartum bleeding such as multiple births, large fetuses, multiple abortions,... Using drugs to increase uterine contractions Correct indications and doses, closely monitor labor factors. Perform obstetric surgery and procedures according to indications, conditions and techniques. Active management of the third stage of labor. When an accident occurs, it is necessary to find out the causes of bleeding early, treat it according to the right and timely causes to avoid its consequences and reduce the mortality rate due to bleeding.

Is a condition that threatens the life of the fetus, the fetal health and the future mental and motor development of the child, the cause of 1/3 of all perinatal deaths. Acute fetal distress is a consequence of gas exchange disorders between mother and child during labor, causing the fetus to be deprived of oxygen.
Causes: Due to intense uterine contractions, prolonged labor, due to pregnancy: preterm pregnancy, old term pregnancy, fetal growth retardation, maternal disease,... Especially acute fetal failure due to placental cord prolapse ; The fetal mortality rate is very high if not detected and treated promptly.
Prevention:
Good pregnancy management, detection and treatment of high-risk pregnancies that can cause fetal distress in labor: old-term pregnancy... Closely monitor labor to detect and predict Prevention of pregnancy failure for timely treatment: correcting uterine contractions if contractions are intense... In cases where amniotic fluid is reduced, the amniotic index is less than 30 mm, cesarean section should be performed, should not be challenged for lower birth.

Is a very dangerous obstetric complication, high mortality rate for mother and fetus. Embolism is caused by amniotic fluid, fetal cells, substances, hair, fuzz, tissue fragments or thrombus entering the maternal circulation causing respiratory failure and acute circulatory failure.
Prophylaxis: Embolism is an unpredictable, non-preventable, and in most cases untreatable obstetric complication. However, the disease is likely to occur in the elderly, multiple births, multiple pregnancies, placenta previa, preeclampsia.... In labor, sudden rupture of membranes, surgical intervention... is also a risk factor.
Therefore, during labor, close labor monitoring, early detection of abnormal signs and symptoms, rapid and active resuscitation and timely supportive treatment are prerequisites that can bring hope. save the lives of mothers and babies.
To avoid the risk of amniotic fluid embolism, it is necessary to manage pregnancy well, especially high-risk pregnancies.

During labor, the fetus may suffer injuries: Shoulder, clavicle fracture, limb injury, brachial plexus paralysis....
Cause:
Due to preterm pregnancy, large fetus, Abnormal pregnancy position, pathological pregnancy... Intervention procedures: forceps, trauma suction... Prevention:
Good pregnancy management, timely detection of high-risk pregnancy cases: pregnancy Prematurity, gestational diabetes ...
Intervention with gentle procedures, correct indications, qualified conditions and correct techniques.

Eclampsia is diagnosed when seizures occur in a pregnant woman with symptoms of preeclampsia and there is no other cause to explain. It is one of the main causes of maternal and fetal death.
Cause : A complication of preeclampsia.
Prevention:
Monitoring and managing pregnancy, appropriate treatment of pre-eclampsia to reduce serious complications for mother and fetus.
At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormalities Maternity package helps to facilitate the process. birthing process Newborns get comprehensive care

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