Prolonged Labour

Parturition lasting over twenty - four hours is defined as prolonged labour . It is often due to weak contraction and forceless contraction of the womb , or narrow pelvic fetal and malposition of fetus .

Etiology and Pathogenesis

a ) Deficiency of qi and blood : Weak constitution with insufficient qi , exhaustion through premature contraction , premature amenorrhea , and depletion of blood due to hemorrhage , all lead to prolonged labor . In Understanding of Childbirth , it says , Physical weakness and early exertion of force have exhausted the mother before the baby is delivered and thus the baby gets stuck . Dryness in the vagina also brings about difficult delivery .

b ) Qi stagnation and blood stasis : Fear or too much worry over the forthcoming delivery retards qi and stagnates blood . Extreme leisure during gestation leads to impaired flow of qi and blood . Affection of external cold during delivery binders the circulation of qi and blood . All of them are causative factors of prolonged labor . Just as Golden Mirror of Medicine says , Prolonged labor derives from various factors such as seeking comfort and ease and too much sleep , both of which lead to retarded flow of qi ; or from fright and worry over the oncoming labor . . . and obstruction of vagina by blood stasis from an injured uterus .

Differentiation

a ) Deficiency of qi and blood : Main manifestations : Dull and paroxysmal labor pains with mild weighing and distending sensation , or profuse hemorrhage in light color , pale complexion , lassitude , palpitation , shortness of breath , pale tongue , weak pulse .

Analysis : Since both qi and blood are deficient and the puerperant is too weak to have uterus contraction , there are mild abdominal pain , mild heavy and distending sensation , and the delivery duration is prolonged . Qi deficiency leads to profuse hemorrhage in light color , pale complexion , lassitude , palpitation , and shortness of breath . Pale tongue and weak pulse are signs of deficiency of qi and blood .

b ) Qi stagnation and blood stasis : Main manifestations : Sharp pains in the waist and abdomen , scanty hemorrhage in dark red color , prolonged delivery course , dark bluish complexion , depressive mood , fullness in the chest and epigastruim , frequent nausea , dark tongue , deep forceful pulse .

Analysis : The retarded circulation of qi and blood gives rise to the sharp pain in the waist and abdomen and prolonged course of delivery . The stagnated qi does not ascend as usual , bringing about the dark bluish complexion , fullness and distension in the chest and epigastrium , and frequent nausea . The dark tongue , deep and forceful pulse indicate qi stagnation and blood stasis .

Treatment

a ) Deficiency of qi and blood : Method : Points are chiefly chosen from the Foot - Yangming and Foot - Taiyang Meridians . Acupuncture is given with the reinforcing method with moxibustion to tonify qi and blood , and quicken the delivery .

Prescription : Zusanii ( S 36 ) , Sanyinjiao ( Sp 6 ) , Zhiyin ( B 67 ) .

Explanation : Zusanii ( S 36 ) and Sanyinjiao ( Sp 6 ) may generate qi and blood and tonify the spleen and stomach , while Zhiyin ( B 67 ) is an effective and empirical oxytocic point . The three points thus used together fulfill the set purpose of tonifying qi and blood and quickening the delivery .

b ) Stagnation of qi and blood : Method : Points are chiefly chosen from the Hand - Yangming and Foot - Taiying Meridians . Acupuncture is given with the reducing method to regulate qi and blood , activate qi so as to quicken the delivery .

Prescription : Hegu ( Li4 ) , Sanyinjiao ( Sp 6 ) , Zhiyin ( B 67 ) .

Explanation : Hegu ( LI 4 ) is the Yuan - ( Primary ) Point of the Hand - Yangming Meridian and Sanyinjiao ( Sp 6 ) is an intersecting point of the three foot yin meridians . The two paired together may regulate qi and blood , clear off stasis and speed up the delivery . Zhiyin ( B 67 ) is an effective and empirical oxytocic point .

Remarks

Acupuncture and moxibustion carry an oxytocic effect to the prolonged labour due to weak uterine contraction . Measures other than acupuncture and moxibustion should be taken in case of prolonged labor caused by uterine deformity or contracted pelvis .