Maternal Distress

Subject: Midwifery II (Theory)

Overview

Maternal distress is a period defined by maternal dehydration, abnormal vital signs, and ketoacidosis during childbirth. It is an indicator that the labor should be terminated. In primigravidae, inefficient uterine construction such as hypotonic, hypertonic, incoordinate uterine activity, malpresentation/malposition, CPD, Contracted pelvis, and inflexible pelvic floor and perineum body can cause maternal pain. One of the first signs of discomfort is an increase in pulse rate, which may be 120 or more beats per minute, as well as a rise in temperature, labored restlessness, weakness and sweating, abdominal distension, and so on. Good nursing care includes surveillance from the start to prevent mother distress, such as pulses, respiration, temperature, blood pressure, fluid intake, urine output, FHS, and so on.

Maternal distress is a condition in which a woman's emotional and physical weariness during labor is induced by protracted labor and is characterized by maternal dehydration, abnormal vital signs, and ketoacidosis. It is a sign that the work should be stopped.

Causes

  1. Contracted pelvis
  2. CPD
  3. Big baby in relation to the maternal pelvis
  4. Malpresentation/malposition
  5. Rigid cervix
  6. Rigid pelvic floor and perineum body in primigravidae
  7. Obstructive labor
  8. Inefficient uterine construction: Hypotonic, hypertonic, incoordinate uterine action.
  9. Maternal bearing down/pushing from the first stage of labor.

Sign and Symptoms

  1. One of the first signs of distress is an increase in pulse rate, which can reach 120 beats per minute or more.
  2. Temperature increase
  3. Anxious expression with a troubled expression.
  4. Restlessness, weakness, and sweating were all noticeable.
  5. Severe dehydration; dry lips, dry and coated tongue, acetone in breath and urine
  6. Distension of the abdomen
  7. Vomiting in the dark
  8. An increase in respiration rate of around 24-26/min.
  9. A woman may die as a result of improper and timely management.

Management of Maternal Distress

  1. Preventing maternal distress requires enough rest, sedation, dehydration, and avoiding prolonged labor.
  2. Good nursing care includes monitoring pulses, respiration, temperature, blood pressure, fluid intake, urine output, FHS, and other parameters to prevent maternal distress from the start of labor. Everything should have been documented earlier.
  3. Encourage bladder emptying every 2 hours.
  4. Encourage and provide plenty of fluids on a regular basis.
  5. Give the woman reassurance and emotional support.
  6. When indicators of maternal distress are observed, contact a doctor promptly.
  7. To treat dehydration and ketoacidosis, administer an IV infusion of 5-10% dextrose and R/L.
  8. If the concern is observed in relation to the degree of cervical dilatation and the course of labor, seek medical attention. Labor can be terminated early in the first stage by cesarean section, and in the second stage by episiotomy, vacuum delivery, or forceps delivery.
  9. Allow for total rest following birth.

References

  • https://www.ncemch.org/knowledge/maternaldistress.php
  • Tuitui, Roshani, and S. N. Dr. Suwal. Manual of Midwifery II (Intrapartum Care). Bhotahity, Kathmandu: Vidyarthi Pustak Bhandar, 2014.
  • https://www.scribd.com/document/307612914/Maternal-Distress
  • http://www.rightdiagnosis.com/medical/maternal_distress_complicating_labor_and_delivery_postpartum_condition_or_complication.htm
  • www.gpnotebook.co.uk/simplepage.cfm?ID=-60096477
Things to remember
  • Maternal distress is a condition in which a woman's emotional and physical weariness during labor is induced by protracted labor and is characterized by maternal dehydration, abnormal vital signs, and ketoacidosis.
  • It is a sign that the work should be stopped.
  • In primigravidae, inefficient uterine construction such as hypotonicity, hypertonia, incoordinate uterine movement, malpresentation/malposition, CPD, contracted pelvis, inflexible pelvic floor, and perineum body can cause maternal suffering.
  • The clinical signs of maternal distress include an increase in the pulse rate, which may be 120 or more beats per minute, a rise in temperature, noticeable restlessness, weakness and sweating, abdominal distension, and so on.
  • Good nursing care includes monitoring pulses, respiration, temperature, blood pressure, fluid intake, urine output, FHS, and other parameters to prevent maternal distress from the start of labor.
  • Everything should have been documented earlier.
  • If the concern is observed in relation to the degree of cervical dilatation and the course of labor, seek medical attention.
  • Labor can be terminated early in the first stage by cesarean section, and in the second stage by episiotomy, vacuum delivery, or forceps delivery.
Questions and Answers

The condition known as maternal distress refers to the woman's mental and physical exhaustion during labor, which is typically brought on by prolonged labor and is characterized by maternal dehydration, altered vital signs, and ketoacidosis. It is a sign that the labor ought to be stopped.

Causes

Extended labor because:

  • Shortened pelvis
  • CPD
  • Large infant in proportion to the mother's pelvis
  • Malpresentation/malposition
  • Stiff cervix
  • Rigid perineum and pelvic floor in first-time mothers
  • Inefficient labor
  • Ineffective uterine design: Uncoordinated, hypotonic, and hypertonic uterine action
  • Maternal pressing or bearing down during the early stages of labor.

Management of Maternal Distress

  • In order to reduce maternal discomfort, pregnant women should get enough rest, be sedated, drink plenty of water, and avoid labors that last too long.
  • Good nursing care includes monitoring pulses, respiration, temperature, blood pressure, fluid intake, urine output, FHS, and other parameters to prevent mother discomfort from the start of labor. Everything has to be recorded sooner.
  • Encourage the bladder to empty every two hours.
  • Encourage and provide access to plenty of fluids on a regular basis.
  • Assure the woman and offer her emotional support.
  • As soon as you see any indicators of maternal discomfort, consult a doctor right once.
  • Give a 5–10% dextrose IV infusion together with R/L to treat keto acidosis and dehydration.
  • If discomfort is evident, labor should be accelerated in accordance with the degree of cervical dilatation and the stage of the labor, so seek medical attention. A caesarian section may be used to end labor in the early stages of the first stage, and episiotomies, vacuum deliveries, and forceps deliveries are frequently used to end labor in the second stage.
  • After delivery, give yourself a thorough rest.

© 2021 Saralmind. All Rights Reserved.