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1、RENJI HOSPITALdystociaTeng YinchengDate 1RENJI HOSPITALDefinitionDystocia literally means difficult labor and it is characterized by abnormally slow progress of laborIt is the consequence of four distinct abnormalities that may exist singly or combinationDate 2RENJI HOSPITALuAbnormal of the powers(u
2、terine contractility and maternal expulsive effort)uAbnormalities of passenger(the fetus)uAbnormalities of the passage(the birth canal)Categories of dystociaDate 3RENJI HOSPITALAbnormalities of the powersUterine dysfunction hypotonic primaryuterine inertia secondaryUterine hypertonicDysfunction uter
3、ine hypercontractilityDate 4RENJI HOSPITALAbnormalities of the powersDate 5RENJI HOSPITALAbnormalities of the powers-uterine inertia1.Etiology of uterine inertiauCephalopelvic disproportion or Fetal malposition uAbnormal of uterine muscleuImbalance of endocrine systemuAdministration of analgesiaupsy
4、chical-factorsuOthers fatigueDate 6RENJI HOSPITALAbnormalities of the powers-uterine inertia2.Clinical findingsFailure to progressv Lack of progressive cervical dilatationProlonged latent phaseProlonged active phaseProtracted active phaseProlonged second phasev Lack of fetal decentProlonged descentP
5、rotracted descentProlonged laborDate 7RENJI HOSPITALAbnormalities of the powers-uterine inertia3.diagnosisPalpation: strength duration frequencyTocodynamometerVaginal examinationDate 8RENJI HOSPITALDate 9RENJI HOSPITALDate 10RENJI HOSPITALAbnormalities of the powers-uterine inertia4.Effect on matern
6、al and fetusmaternal fatigueacidosisinfectionpostpartum hemorrhagecesarean section ratefetus birth injury distressprolapse of umbilical cordstillbirthDate 11RENJI HOSPITALAbnormalities of the powers-uterine inertia5.managementhypotonic general managementphysical methodsdrugsHypertonic SedativeDate 1
7、2RENJI HOSPITALAbnormalities of the powers- hypercontractility1.Clinical findings and diagnosisPrecipitate deliveryConstriction ring of uterusTetanic contractionof uterusDate 13RENJI HOSPITALAbnormalities of the powers- hypercontractility2.Effect on maternal and fetus Precipitate delivery soft birth canal trauma Rupture of uterus Fetal distress Fetal death stillbirthDate 14RENJI HOSPITALAbnormalities of the powers- hypercontractility3.managementvProphylaxisvTocolytic therapiesvForcepvoperationDate 15
