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Introduction to Complications of Labor and Delivery

By Julie S. Moldenhauer, MD, Associate Professor of Clinical Obstetrics and Gynecology in Surgery, The Garbose Family Special Delivery Unit; Attending Physician, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia; The University of Pennsylvania Perelman School of Medicine

Usually, labor and delivery occur without any problems. Serious problems are relatively rare, and most can be anticipated and treated effectively. However, problems sometimes develop suddenly and unexpectedly. Regular visits to a doctor or certified nurse midwife during pregnancy make anticipation of problems possible and improve the chances of having a healthy baby and safe delivery.

Problems may involve

  • The timing of labor—whether labor occurs earlier or later than normal

  • Problems in the fetus or newborn

  • Problems in the mother

  • A problem with the placenta called placenta accreta

Placenta accreta may be discovered during pregnancy or only after delivery.

Most problems are obvious before labor begins. Such problems include

Some problems (complications) that women develop during pregnancy can cause problems during labor or delivery. For example, preeclampsia (high blood pressure with protein in the urine) may lead to premature detachment of the placenta from the uterus (placental abruption) and problems in the newborn.

Some problems develop or become obvious during labor or delivery. Such problems include

When complications develop, alternatives to spontaneous labor and vaginal delivery may be needed. They include

Some problems occur immediately after delivery of the fetus, around the time the placenta is delivered. They include

Fetal distress, respiratory distress in the newborn, and uterine rupture are uncommon complications of labor.

Timing of Labor and Delivery

No more than 10% of women deliver on their specified due date (usually estimated to be about 40 weeks of pregnancy). About 50% of women deliver within 1 week (before or after), and almost 90% deliver within 2 weeks of the due date.

Did You Know...

  • Only about 10% of women deliver their baby on their due date.

Labor may start

  • Too early (preterm): Before the 37th week of pregnancy

  • Late (postterm): After the 42nd week of pregnancy

In such cases, the health or life of the fetus may be endangered.

Labor may be early or late because the woman or fetus has a medical problem or the fetus is in an abnormal position.

Determining the length of pregnancy can be difficult because the precise date of conception often cannot be determined. Early in pregnancy, an ultrasound examination, which is safe and painless, can help determine the length of pregnancy. In mid to late pregnancy, ultrasound examinations are less reliable in determining the length of pregnancy.

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