Dystocia Flashcards
Definition of dystocia
a long, difficult, abnormal labor that prevents dilation, effacement, and decent
Definition of Eutocia
Normal birth
What are the 5 P’s
Powers, Passage, Passenger, Positioning, Psychological
What is the primary power with dystocia?
Abnormal uterine contractions that prevent normal cervical dilation and effecement
What is the secondary power with dystocia?
Abnormal fetal descent through the pelvis
What is a precipitous power and what does it cause?
Labor that lasts less than 3 hours– causes intense pain with contractions and no rest periods
What is hypertonic uterine dysfunction?
painful, frequent contractions that occur in the early phase (cervic <4cm), uncoordinated contractions and the uterus doesnt completely relax.
How do you treat hypertonic uterine dysfunction?
Rest and relax the mother and uterus, analgesics
What is hypotonic uterine dysfunction?
More common- after progressive labor, contractions stop, usually from malposition
How do you treat hypotonic uterine dysfunction?
Ultrasound to determine fetal position, FHR and pattern
Nursing diagnoses related to uterine dysfunction
Risk of injury due to prolonged labor, acute pain, anxiety
What are causes of precipitous labor?
Having babies before, large pelvis or small fetus, cocaine abuse
What are some complications of precipitous labor?
uterine rupture, laceration of birth canal, amniotic fluid embolism, fetal hypoxia, intracranial hemorrhage
What is pelvic dystocia?
Contractures of the pelvic diameters that reduce the capacity of the outlet
What causes pelvic dystocia?
congenital abnormalities, maternal malnutrition, neoplasms, spinal disorders
What is soft tissue dystocia?
An obstruction in birth passage from placenta previa, a full pladder, swollen cervic, etc.
What are some fetal causes of dystocia?
Abnormalities- hydrocephalus, tumors, neural tube defects, large weight (over 4000g), malposition, malpresentation, multiple fetuses
What is a malposition of a fetus?
Occipitoposterior
How do you correct occipitoposterior position?
Rotate the fetus or go for C section– find cord with ultrasound before moving
Position of mother for good delivery
squatting or upright
Psychological responses related to dystocia
anxiety, apprehension, hormones and neurotransmitters
What is prolonged labor and risks associated with it?
Labor lasting longer than 24 hours with risks being fatigue, pain, overdistended uterus and hemmorrhage, and hypoxia to fetus
What is treatment methods of dystocia?
Position mother, monitor FHR, monitor maternal VS, maintain comfort and communication and support family
What is a type of chemical cervical ripening?
Postaglandin E- softens and thins the uterus (Misoprostol/Cytotex)
