1. 仁济医院 RENJI HOSPITAL dystocia Teng Yincheng Teng Yincheng

2. RENJI HOSPITAL 2 Definition Dystocia literally means difficult labor and it is characterized by abnormally slow progress of labor It is the consequence of four distinct abnormalities that may exist singly or combination Dystocia literally means difficult labor and it is characterized by abnormally slow progress of labor It is the consequence of four distinct abnormalities that may exist singly or combination

3. RENJI HOSPITAL 3  Abnormal of the powers(uterine contractility and maternal expulsive effort)  Abnormalities of passenger(the fetus)  Abnormalities of the passage(the birth canal)  Abnormal of the powers(uterine contractility and maternal expulsive effort)  Abnormalities of passenger(the fetus)  Abnormalities of the passage(the birth canal) Categories of dystocia

4. RENJI HOSPITAL 4 Abnormalities of the powers Uterine dysfunction hypotonic primary uterine inertia secondary Uterine hypertonic Dysfunction uterine hypercontractility Uterine dysfunction hypotonic primary uterine inertia secondary Uterine hypertonic Dysfunction uterine hypercontractility

5. RENJI HOSPITAL 5 Abnormalities of the powers

6. RENJI HOSPITAL 6 Abnormalities of the powers -----uterine inertia 1.Etiology of uterine inertia  Cephalopelvic disproportion or Fetal malposition  Abnormal of uterine muscle  Imbalance of endocrine system  Administration of analgesia  psychical-factors  Others fatigue 1.Etiology of uterine inertia  Cephalopelvic disproportion or Fetal malposition  Abnormal of uterine muscle  Imbalance of endocrine system  Administration of analgesia  psychical-factors  Others fatigue

7. RENJI HOSPITAL 7 Abnormalities of the powers -----uterine inertia 2.Clinical findings Failure to progress  Lack of progressive cervical dilatation Prolonged latent phase Prolonged active phase Protracted active phase Prolonged second phase  Lack of fetal decent Prolonged descent Protracted descent Prolonged labor 2.Clinical findings Failure to progress  Lack of progressive cervical dilatation Prolonged latent phase Prolonged active phase Protracted active phase Prolonged second phase  Lack of fetal decent Prolonged descent Protracted descent Prolonged labor

8. RENJI HOSPITAL 8 Abnormalities of the powers -----uterine inertia 3.diagnosis Palpation: strength duration frequency Tocodynamometer Vaginal examination 3.diagnosis Palpation: strength duration frequency Tocodynamometer Vaginal examination

9. RENJI HOSPITAL 9

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11. RENJI HOSPITAL 11 Abnormalities of the powers -----uterine inertia 4.Effect on maternal and fetus maternal fatigue acidosis infection postpartum hemorrhage cesarean section rate fetus birth injury distress prolapse of umbilical cord stillbirth 4.Effect on maternal and fetus maternal fatigue acidosis infection postpartum hemorrhage cesarean section rate fetus birth injury distress prolapse of umbilical cord stillbirth

12. RENJI HOSPITAL 12 Abnormalities of the powers -----uterine inertia 5.management hypotonic general management physical methods drugs Hypertonic Sedative 5.management hypotonic general management physical methods drugs Hypertonic Sedative

13. RENJI HOSPITAL 13 Abnormalities of the powers ----- hypercontractility 1.Clinical findings and diagnosis Precipitate delivery Constriction ring of uterus Tetanic contraction of uterus 1.Clinical findings and diagnosis Precipitate delivery Constriction ring of uterus Tetanic contraction of uterus

14. RENJI HOSPITAL 14 Abnormalities of the powers ----- hypercontractility 2.Effect on maternal and fetus  Precipitate delivery  soft birth canal trauma  Rupture of uterus  Fetal distress  Fetal death  stillbirth 2.Effect on maternal and fetus  Precipitate delivery  soft birth canal trauma  Rupture of uterus  Fetal distress  Fetal death  stillbirth

15. RENJI HOSPITAL 15 Abnormalities of the powers ----- hypercontractility 3.management  Prophylaxis  Tocolytic therapies  Forcep  operation 3.management  Prophylaxis  Tocolytic therapies  Forcep  operation