Obstetrics - Dystocia

Question 1

Dystocia

Answer 1

Difficult child birth

• Maternal
• Fetal
• Mechanical Factors

Question 2

Maternal Factors

Answer 2

Inefective uterine contraction:

• Often occurs in nulliparous women with a prolonged labour

Maternal illness:​

• Diabetes Mellitus, pre-eclampsia, eclampsia

Problematic placental implantation

• placental praevia

Question 3

Fetal Factors

Answer 3

Fetal Malpresentation

Macrosomia: associated with maternal diabetes

Question 4

Mechanical Factors

Answer 4

Cephalopelvic disproportion: 4 broad anatomical types of female pelvis

1. Gynecoid
2. Android
3. Anthropoid
4. Platypelloid

Shoulder Dystocia:

• Shoulder dystocia is a specific case of obstructed labour whereby after the delivery of the head,
• the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below, the pubic symphysis.
• It is diagnosed when the shouldersfail to deliver shortly after the fetal head.
• associated wth DM, macrosomia, small maternal size
  
  • Past history of shoulder dystocia

Management:

• McRobert’s manouvre
• Woods screw procedure
• Zavanelli procedure