异常分娩［英文］课件.pptVIP

* Shoulder presentation Shoulder presentation occurs when the long axis of the fetus is approximately perpendicular to that of the usually over the pelvic inlet,with the head lying in one iliac fossa and the breech in the other. * * ?Diagnosis outline of dystocia ★Antepartum ：Regularly prenatal care ★During labor：Symptoms: abnormal progress of labor or arrest. Preparatory division: rule out false labor。 Dilatation division: rule out cephalopelvic disproportion . Pelvic division: rule out abnormal fetal presentation and position. * ★Pay attention to etiology diagnosis Pregnant women condition. Arrested fetal head descending. Prolonged cervical dilation. Dysfunction of uterine. Premature rupture of membrane. Abnormal of fetus. * Management： Evaluation of uterine contraction,fetal size and position,pelvic size, fetopelvic disproportion or not. Prolonged latent stage： Sedation may cause absence of uterine contraction in false labor。 。 * Prolonged active stage： Observe the progress of labor 、expulsive force、fetal heart rate、fetal position for 2～4h,when rule out the fetopelvic disproportion. * Prolonged second stage of labor： The first, perform vaginal examination to rule out fetopelvic disproportion , correct the abnormal fetal position,then can improve the uterine contraction by oxytocine . * ★Ceasrean section ?posterior asynelitism、Anterior asynelitism )、Brow presentation; ?General pelvic contract ?Fetal macrosomia; ?Shoulder presentation, Feet presentation; ?Pathologic contracting ring; * pelvic contract Fetal macrosomia uterine inertia Abnormal fetal position Fetal distress Threatened uterine rupture ruputre member or oxytocine unsuccess progress