异常分娩(英文)

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Hypertonic of uncoordinated contraction
Constriction ring of uterus Characteristic:
Local smooth muscle in uterus spasmodicly contract to form circular contraction. The ring is located at juncture between lower uterine segment and corpus uteri.
Simple flat pelvis
Rachitic flat pelvis
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Midpelvis contraction
Midpelvis contraction is defined as values less than 10 cm for the interspinous diameter, always occurs in android pelvis and anthropoid pelvis.
2
Cause of dystocia
Power Passage Passeng Psyche
3
Diagnosis:
prolonged courses of ck of progressive cervical dilatation and fetus descending.
prolonged latent phase >16h。
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Abnormal passage
Causes of abnormalities of passage include bony abnormalities (pelvic dystocia), soft tissue obstruction of the birth canal. Pelvic dystocia, particularly that due to small bony architecture, is the most common cause of passage abnormalities.
Improve the contraction
Rupture the membrane Oxytocin stimulation of labor:from low dose.
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In second stage of labor
★There is no cephalopelvic disproportion：improve the expulsive force ★Fetal distress: finish the labor in shortest time； ★Cephalopelvic disproportion ：cesarean section In third stage of labor ：prevention of postpartum hemorrhage
The rhythm, symmetry, polarity and retraction of uterine contraction become abnormal.
Include：uterine hypocontractility
uterine hypercontractility
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Abnormalities of the powers Uterine dysfunction
prolonged active phase >8h Cervical dilation: Primigravida<1.2cm/h， Multipara <1.5cm/h。
4
Protracted active phase
The cervical dilation stop for 2 hours in active phase。
Manifestation and diagnosis
The contraction have normal rhythm 、 symmetry and polarity,but the intensity is too strong.
Precipitate delivery:
The total stage is less than 3 hours when the rates of cervical dilation is more than 5cm/h, the cervical dilation of 10cm and expulsion of fetus occurs in short time.
★Evaluate fetus and maternal complexion.
★Oxytocin infusion:
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Management of coordinated dysfunction
In the first stage of labor
Relax, Take good care, Narcotic agent;
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Pelvic contraction
Type of Pelvic:
female
male
andropoid pelvis
platypelloid pelvis25
female inlet outlet
male
cavity
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Contracted pelvic inlet platypelloid is comon The platypelloid pelvis is characterized by a transverse diameter that is wide with respect to the anteroposterior diameter.
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Contracted pelvic outlet
Pelvic outlet contraction is defined as values less than 8cm for the intertuberous diameter and the sum of the intertuberous and posterior sagittal diameter less than 15cm. always occurs in android pelvis
11
Clinical manifestation
1.Hypotonic uterine action(coordianted)
★ Have normal rhythm 、symmetry and polarity,
★But the intensity is low, including: primary and secondary hypotonic uterine action.
§Prevention is main doctrine ; § Use oxytocin, clysis, artificial rupture of membrane carefully ; § Aspiration oxygen, prohibit uterine contraction— Magnesium sulfate, pethidine; § Fetal distress,pathologic retraction ring--Cesarean 。
★ The pregnant women will fell persisting pain.
13
Effect on maternal and fetus
maternal
Fatigue
Acidosis Infection Postpartum hemorrhage Cesarean section rate increasing
ABNORMAL LABOR OR DYSTOCIA
1
Defintion：
Dystocia is defined as difficult labor.It may be associated with various abnormalities that prevent or deviate from the normal course of labor and delivery.It is the consequence of four distinct abnormalities that may exist singly or combination: the power, passage passenger and the psyche.
fetus
distress Prolapse of umbilical cord Stillbirth
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Birth injury
Managemant
1 . Coordinated dysfunction
★Vaginal examination to rule out
Cephalopelvic disproportion or fetal malposition ；
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2、hypotonic uterine action(uncoordianted)
★ loss the normal rhythm 、symmetry and polarity. ★ the intensity in the periods of relaxation between contractions become larger.
Protracted descent: Prolonged labor:
24h。
fetus
descending
in
deceleration phase stop for more than 1h。
the total stage last more than
6
7
8
Abnormal uterine action