Most deliveries go smoothly. When all the controls have been carried out during the pregnancy and the gestation has developed normally, the delivery usually occurs without unforeseen events.
However, there are rare complications that can occur at the time of delivery, most of which lead to cesarean section. Let’s see some of them:
No progression of labor
It is one of the most common complications of giving birth along with fetal distress. Labor can be diverted causing abnormal patterns in contractions, dilation of the cervix, or the descent of the fetus through the birth canal.
There are factors that can influence such as the disproportion between the mother’s pelvis and the baby’s head, inducing labor with a very closed neck or an abnormal presentation of the baby.
The contractions become too weak and irregular, stalling the dilation of the cervix and the progression of labor. To solve this, labor is usually induced with venous oxytocin, a synthetic hormone that stimulates labor contractions. You can also resort to maternal rest or change in the mother’s position. If the labor still does not progress and there may be a risk to the mother or the baby, the use of forceps or caesarean section is used.
Fetal suffering
The baby is monitored at all times during delivery. If worrisome changes in the baby’s heart rate are detected that confirm that he is not receiving the necessary oxygen, it is talk of loss of fetal well-being or fetal distress. Another sign that it may exist is the presence of meconium in the amniotic fluid, a sign that you are suffering from a lack of oxygen. In this case, an emergency cesarean section is performed as the baby could aspirate the meconium and cause lung problems.
There are many reasons why fetal distress can occur in the baby: maternal fever during delivery, compression of the vena cava due to the mother’s delivery position, alterations in the placenta, short cord, infections, malformations, etc.
Some of the factors that can predispose to fetal distress during childbirth are: maternal age (less than 20 and more than 35 years old), being the first childbirth or having had many previous deliveries, hypertension, diabetes or maternal infection, history of fetal death , prematurity or malformations.
In each case, the doctor will assess whether a cesarean section is necessary or the vaginal delivery can be continued with close monitoring.
Cord prolapse
It occurs when once the bag of waters has been broken, the umbilical cord protrudes through the cervix before the baby’s head. It is rare that it happens, there is one case in 1,000, but it poses a serious risk.
The pressure of the head on the cord could compress it, interrupting the flow of oxygen to the baby. You can see your heart rate drop on the monitor. When there is a prolapsed cord, it is necessary to perform an emergency cesarean section to prevent the baby from suffering an injury due to lack of blood. Until the intervention occurs, the baby’s head is pushed to avoid pressure on the cord.
A cord prolapse with the pouch can also occur when the cord is in front of the fetal head but does not protrude through the vagina. On the other hand, it is called hidden cord prolapse when it is not in front, but next to the presentation of the baby.
Prolapse can occur whether the baby is on the breech or cephalad, but this is the most dangerous because the pressure exerted by the head on the pelvis tends to be more intense.
Among the factors that predispose to cord prolapse are: prematurity and low weight, twin pregnancies, alteration in the presentation of the baby or alterations of the maternal pelvis.
Twists of cord
30% of children are born with cord wraps. It is a frequent situation that in most cases does not represent a risk for the baby.
The most frequent is that the baby presents a circular cord, but it can have up to four depending on its length and only in some occasions it can be detected by means of an ultrasound. Most of the time, the doctor is aware of it when the baby’s head is poking out.
The cord may be wrapped around the baby’s neck, arm, chest, or leg, and in certain cases the doctor may perform a maneuver to slide or cut the cord if it is too tight.
However, with the pressure of labor contractions and descending through the birth canal, the cord can tighten, reducing the flow of blood between mother and baby, which can cause fetal distress. If the monitor shows alterations in the heart rhythm or the cord twists prevent the baby from descending, a caesarean section should be performed.
Shoulder dystocia
It is a rare complication in cephalic presentations, that is, when the baby is placed head down. It occurs when the head sticks out but the baby’s shoulder is stuck against the mother’s pelvic bone .
The doctor will try to unblock the shoulder through obstetric maneuvers to prevent injury to the nerves in the baby’s shoulder, neck, or a broken collarbone. An attempt will be made to continue with the vaginal delivery, but if the attempt fails and poses a risk of suffocation, a cesarean section is performed.
Shoulder dystocia cannot always be prevented, it is a complication that arises at the time of giving birth, but there are risk factors such as: large babies (macrosomia), gestational diabetes, mother’s obesity, small pelvis, prolonged pregnancy, excessive weight gain during pregnancy or a history of shoulder dystocia.
Placental abruption
It is a serious complication that occurs when the placenta separates from the wall of the uterus before the baby is delivered. The detachment can be partial or total and can happen at any time during pregnancy or at the time of delivery.
When the placenta detaches from the uterus during childbirth, the contractions can facilitate detachment and cause bleeding. As the placenta detaches, the supply of blood flow and oxygen to the baby is cut off. Your doctor will assess your risk depending on the degree of detachment, so you may decide to perform a cesarean section.
The risk factors that can predispose it are: hypertension of the mother, heart disease, diabetes, tobacco, drug abuse, alcohol and advanced age of the mother.
Amniotic fluid embolism or embolism
It is a very rare (1 x 30,000 cases) and fatal complication, with a mortality rate in 80 percent of cases. It is one of the most frequent causes of obstetric death.
It occurs, usually in complicated deliveries, when a pulmonary artery of the mother is blocked by amniotic fluid.
An embolus formed by amniotic fluid enters the maternal blood circulation and goes to the lungs, obstructing an artery and can cause alteration of the mother’s heart rhythm, respiratory failure, collapse or cardiac arrest.
If it occurs, the doctor must deliver the baby urgently by cesarean section and care for the mother.
Some of the risk factors include: advanced maternal age, intense uterine dynamics, prolonged pregnancies, and insertion of monitoring materials.
These are some of the complications that can occur in childbirth at the time of giving birth, which although they are rare, can occur and make the doctor make the most appropriate decisions for the health of the mother and the baby.
In Babies and more | Suffering or loss of fetal well-being: what it is, what are its symptoms and what causes it, Delayed intrauterine growth: what are the consequences of the baby growing less than normal in pregnancy
