Dystocia Flashcards
What is dystonia
dystonia is a long difficult labor
Dystonia problems related to primary power
abnormal uterine contractions preventing normal cervical dilation and effacement
dystonia precipitous powers
labor lasting less than 3 hrs; hypertonic contractions
hypertonic uterine dysfunction related to dystonia
painful, frequent contractions that occur in the first phase of labor that are usually uncoordinated contractions where the uterus does not completely relax
hypotonic uterine dysfunction related to dystonia
after active progression of labor progression becomes weak or stops all together
cause for precipitous labor
multipara, large pelvis, small fetus, previous precipitous births, cocaine abuse
treatment for precipitous labor
maternal uterine rupture, laceration of the birth canal, amniotic fluid embolism, fetal hypoxia, intracranial hemorrhage
pelvic dystocia
contractures of the pelvic diameters reducing the capacity of the outlet
causes for pelvic dystocia
congenital abnormalities, maternal malnutrition, neoplasm, lower spinal disorders
fetal causes for dystocia
hydrocephalus, tumors, neural tube defects, cephalopelvic disposition, malposition, malpresentation, multifetal pregnancy
what symptoms is present with fetus malposition (occipitoposterior)?
prolonged 2nd stage of labor, severe back pain
treatment for malposition
rotate the fetus externally or c-section
prolonged labor lasts….
more than 24hrs
risks for prolonged labor
fatigue, pain, over distended uterus hemorrhage, hypoxic baby
treatment of dystonia
positioning, augmentation of labor, monitor FHR, maternal VS, maternal comfort measures, communication and support
cervical repening
chemical, mechanical or amniotomy
chemical cervical repening
prostaglandin E (misoprostol) to soften an thin the cervix. this decreases the need to augment labor
Mechanical Cervical Repening
Use of dilators and Foley catheters to stimulate and dilate the cervix
Amniotomy cervical ripening
Artificial rupture of membranes
mechanical ripening
mechanical dilators or Foley catheters to stimulate and dilate the cervix
amniotomy
the artificial rupturing of membranes
oxytocin
a chemical to induce labor that is produced in the posterior pituitary gland
Complications with oxytocin
water intoxication, tetanic contractions, premature separation of the placenta, rupture of uterus, post partum hemorrhage
prolapsed umbilical cord
when the cord lies below the presenting part of the fetus
factors contributing to a prolapsed cord
long cord, fetal malpresentation, transverse lie, unengaged presenting part
forceps-assisted birth
done to shorten the second stage of labor in the case of dystocia
maternal risks and complications related to forceps-assisted birth
laceration of the birth canal, increased swelling, bleed, bruising, hematoma, pelvic floor injuries, increased urinary and rectal incontinence
infant risks and complications related to forceps-assisted birth
cephalhematoma, hyperbilirubinemia, bruising on the face, facial paralysis, retinal hemorrhage, corneal abrasion, other ocular damage
indication for vacuum assistance birth
prolonged second stage of labor, non reassuring heart rate pattern on the fetal strip, relives woman’s pushing efforts when fatigue interferes
prerequisites for vacuum suction delivery
vertex presentation, ruptured membranes, absence of CPD
fetal complications to vacuum suction delivery
scalp lacerations, bruising, cephalohematoma, neonatal jaundice, fractured clavicle, shoulder dystocia, Erb’s paralysis, damage to cranial nerves, retinal hemorrhage, fetal death
