PROLONGED LABOR, WITH SPECIAL REFERENCE TO POSTPARTUM HEMORRHAGE

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Abstract
Prolongation of labor beyond the commonly accepted normal maximum of thirty hours is not only a trying experience for the patient and her family (and for the obstetrician) but also imposes certain considerable maternal and infantile risks. In the child, recent investigations1 emphasize the frequency of death from bacteremia and pneumonia; and in the mother, the course of events may lead to intrapartum fever, shock, sepsis and, sometimes, a fatality.2 The chief of these complications, which is related to the increased danger of intrauterine infection, especially with early rupture of the membranes, has been discussed elsewhere.1c In the course of that study it became apparent that postpartum hemorrhage was more frequent than usual following prolonged labor. This prompted the present investigation. By definition, a labor lasting thirty hours or more is designated "prolonged," one that terminates within three hours is "precipitate" and the remainder are "normal" so

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