Dystocia Flashcards
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Dystocia Define
long, difficult abnormal labor
causes of dystocia
5 P’s
- Powers
- Passage through pelvis
- Passenger (newborn)
- Positioning
- Psychological stress
powers of labor (3)
Primary
Secondary
Precipitous
Primary Power
abnormal contractions
Uterine dysfunction; does not completely relax
Secondary Power
Abnormal fetal descent; more common one
Precipitous Power
Labor that is less than 3 hours
hypertonic contractions
Fetal Station
Station 0 is at ischial spine, just ready to surface
Primary Power Tx
analgesics; help the pt relax
Secondary Power Tx
ultrasound to determine the position of fetus
Pelvic Dystocia causes
- congenital abnormalities
- maternal malnutrition
- neoplasms
- spinal disorders
Soft Tissue Dystocia (tumor of placenta previa)
obstruction in birth passage
Fetus Anomalies
- tumors
- neural tube defects
- hydrocephalus
Malposition
25% in ROP or LOP
Most Common Malpresentation
Breech is most common
But also: frank breech, and complete breech
External Version of Uterus
moving the fetus from breech to head down (vertex) from the outside.
**give a tocolytic if needed to relax the uterus
Most Favorable Position for Birth
upright and squatting is most favorable
*lithotomy– will need to use a vacuum or forceps
Oxytocin (Pitocin)
Used to induce labor, chemically
Prolonged Labor (time)
24+ hours
risks of prolonged labor
- fatigue
- pain
- fetus hypoxia
Nursing Diagnosis for Dystocia
watch for pain
potential for maternal injury
Goals for Dystocia Patient
to educate patient regarding dysfunctional labor
prevent complications
provide support
Tx for Dysctocia
Assist with position, version, augmentation, and cervical ripening
provide support
Cervical Ripening & Stimulation
Prostoglandin E: softens and thins out the cervix
Misoprostol
(give only 1/2 of the tablet)
Oxytocin
stimulates uterine contractions
Given IV
