异常分娩(英文).ppt

* Contracted pelvic outlet Pelvic outlet contraction is defined as values less than 8cm for the intertuberous diameter and the sum of the intertuberous and posterior sagittal diameter less than 15cm. always occurs in android pelvis * Generally contracted pelvic Each pelvic plane is 2cm less than normal value or more, which is called generally contracted pelvic and can be seen in shape more short and small,well-balanced women of type of figure. Pelvic malformation The pelvic loss the normal shape and symmetry. * Contracted pelvic inlet Clinical manifestation ※Abnormal presentation and lie position. ※Lack of progressive cervical dilatation and fetus descending: prolonged latent phase and active phase. ※Premature rupture of membrane and umbilical cord prolapse. * Midpelvis contraction Clinical manifestation: ★Abnormal position Persistent occiput posterior position,or deep transverse arrest ★ Prolonged second stage ★ Forcep increasing * Forceps delivery * Contracted pelvic outlet Clinical manifestation: ?Secondary hypotonic uterine action and protracted second stage of labor. ?The fetal biparietal diameter can’t pass the pelvic outlet. * Management of pelvic bony contraction: Considering type of pelvic,power,fetus position and fetal distress. Contracted pelvic inlet External conjugate 16.5～17.5cm、anteroposterior diameter 8.5～9.5cm. External conjugate 16.0cm、anteroposterior diameter 8.0cm、Cesarea Section * Midpelvis contraction treatment ?Vaginal examination to rule out Cephalopelvic disproportion or fetal malposition ； ?Enhance uterine contractility:oxytocin ?Vaginal delivery or Cesarean section * Pelvic outlet Treatment ?Cesarean section is the first choice. ?When a sum of the intertuberous diameter and the posterior sagittal diameter greater than 15cm, the fetal head may pass the birth canal using the posterior triangle. * Abnormal fetal position persistent occiput posterior position、 persistent occiput transverse position Definition：During th