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Recommendations for augmentation of labour. Highlights and key messages from World Health Organization's 2014 global recommendations.
[Geneva, Switzerland], WHO, 2015 Apr.  p. (WHO/RHR/15.05; USAID Cooperative Agreement No. AID-OAA-A-14-00028.)This evidence brief provides highlights and key messages from the World Health Organization’s 2014 Global Recommendations on the Augmentation of Labor. The goal of the brief is to summarize guidelines for effective interventions for safe augmentation to accelerate their dissemination and use. Additionally, policy and programme actions to incorporate the new guidelines are outlined alongside the recommendations. This brief is intended for policy-makers, programme managers, educators and providers who care for pregnant woman.
British Medical Bulletin. 2003; 67:191-204.Obstructed labour is an important cause of maternal deaths in communities in which undernutrition in childhood is common resulting in small pelves in women, and in which there is no easy access to functioning health facilities with the capability of carrying out operative deliveries. Obstructed labour also causes significant maternal morbidity in the short term (notably infection) and long term (notably obstetric fistulas). Fetal death from asphyxia is also common. There are differences in the behaviour of the uterus during obstructed labour, depending on whether the woman has delivered previously. The pattern in primigravid women (typically diminishing contractility with risk of infection and fistula) may result from tissue acidosis, whereas in parous women, contractility may be maintained with the risk of uterine rupture. Ultimately, tackling the problem of obstructed labour will require universal adequate nutritional intake from childhood and the ability to access adequately equipped and staffed clinical facilities when problems arise in labour. These seem still rather distant aspirations. In the meantime, strategies should be implemented to encourage early recognition of prolonged labour and appropriate clinical responses. The sequelae of obstructed labour can be an enormous source of human misery and the prevention of obstetric fistulas, and skilled treatment if they do occur, are important priorities in regions where obstructed labour is still common. (author's)