上海产科临床医学中心建设规划.pptVIP

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上海产科临床医学中心建设规划.ppt

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上海产科临床医学中心建设规划

RENJI HOSPITAL 仁济医院 RENJI HOSPITAL dystocia Teng Yincheng * Definition Dystocia literally means difficult labor and it is characterized by abnormally slow progress of labor It is the consequence of four distinct abnormalities that may exist singly or combination * Abnormal of the powers(uterine contractility and maternal expulsive effort) Abnormalities of passenger(the fetus) Abnormalities of the passage(the birth canal) Categories of dystocia * Abnormalities of the powers Uterine dysfunction hypotonic primary uterine inertia secondary Uterine hypertonic Dysfunction uterine hypercontractility * Abnormalities of the powers * Abnormalities of the powers-----uterine inertia 1.Etiology of uterine inertia Cephalopelvic disproportion or Fetal malposition Abnormal of uterine muscle Imbalance of endocrine system Administration of analgesia psychical-factors Others fatigue * Abnormalities of the powers-----uterine inertia 2.Clinical findings Failure to progress Lack of progressive cervical dilatation Prolonged latent phase Prolonged active phase Protracted active phase Prolonged second phase Lack of fetal decent Prolonged descent Protracted descent Prolonged labor * Abnormalities of the powers-----uterine inertia 3.diagnosis Palpation: strength duration frequency Tocodynamometer Vaginal examination * * * Abnormalities of the powers-----uterine inertia 4.Effect on maternal and fetus maternal fatigue acidosis infection postpartum hemorrhage cesarean section rate fetus birth injury distress prolapse of umbilical cord stillbirth * Abnormalities of the powers-----uterine in