Abnormal Labor PDF

Abnormal labour Dr. Iman Yousif Abdulmalik Dr. Iman Yousif Abdulmalik secondstage 1 tt E Labfn dilated deliver basinally civil wecannot butport Abnormal labour ; Prolonged labour (dystocia)...

Abnormal labour Dr. Iman Yousif Abdulmalik Dr. Iman Yousif Abdulmalik secondstage 1 tt E Labfn dilated deliver basinally civil wecannot butport Abnormal labour ; Prolonged labour (dystocia) or called dysfunctional labour. poorprogress compromise Fetal Malpresenter The labour becomes abnormal when: There is* poor progress (a delay in cervical dilatation or descent of the fetal presenting part), and or * the fetus shows signs of compromise. *if there is* malpresentation, *malposition, a *uterine scar or * if labour has been* induced, or if there is a *precipitate labour ( in which the onset of labour to birth is an hour or less.) I tear in cervix Obstructed ruptured uterus  Dystocia of labour is defined as difficult labor or abnormally slow progressing labour. *Poor progress of labour occur either in first or second stage of labour: *Progress of labour is depend on three variable (3 P): 1-The powers, i.e. the efficiency of uterine contractions. 2-The passages, i.e., the uterus, cervix, and the bony pelvis. 3-The passenger, i.e., the fetus (with particular respect to the size ,presentation, and position). *Abnormalities in one or more of these factors can slow the normal progress of labour. 1-The powers (inefficient uterine action): This is the most common cause of poor progress in labour. It is more common in primigravidae and perhaps in older women and is characterized by weak and infrequent contractions. The assessment of uterine contractions or Subjective measure of contraction is most commonly carried out by : *Clinical examination ( Palpation). Tocography *External uterine tocography (Tocodynamometer), this can only provide information about the frequency and duration of contractions. Clima Totography MPI *Intrauterine pressure catheters (IUPC) are directly measures the pressure of uterine contraction which give an accurate measurement of the pressure being generated by the contractions, but they are rarely necessary.  Abnormal power *A frequency of 4 to 5 contractions per 10 minutes is usually considered efficient. *Treatment of inefficient uterine contractions is by: *maternal rehydration, *artificial rupture of membranes o_O (ARM), and* intravenous oxytocin (syntocinon). *Uterine contractions may also be extremely irregular and may occur close together in twos and threes, followed by longer periods of inertia. Syntocinon is also effective in correcting this incoordinate uterine activity and usually succeeds in spacing the contractions out more evenly  *Montevideo Units (MVUs) Calculated by multiplying average peak strength of contractions (mmHg) by the number of contractions in 10 minutes. >200 is “adequate” For cervical dilation to occur each contraction must generate 25 mmHg with 50-60 mmHg being considered optimal.  2-The passages, the abnormal bony pelvis and Soft tissues ( uterus, cervix &rigid perineum). Android Tat A. Small pelvis:- 4 types of the pelvis* gynecoid, android, *anthropoid, & *platypelloid. , the gynecoid pelvis is most optimal for à normal delivery, while the others cause àobstructed labour. Abnormal shape of the pelvis due to diseases like rickets, osteomalacia or tuberculosis, tumors of the bones, childhood poliomyelitis affecting the shape of the hips, previous accidents , congenital dislocation of the hips or congenital deformity of the sacrum or coccyx. Kyphosis and Scoliosis, also affect the shape of the pelvis. UBY.it's radian Towers *Pelvimetry is clinical estimation of adequacy of the pelvis. *Contracted Pelvic Inlet Shortest AP Diameter