Dysfunctional labor

Posted by e-Medical PPT Friday, July 13, 2012
 Any deviation in normal progress of labor , either in cervical dilatation or in descent of the presenting part

Etiology
1. Malfunction in the myogenic, neurogenic, or hormonal mechanisms of uterine activity.
2. Malpresentation, fetal anomalies, uterine malformation, pelvic tumors, overdistension of the uterus, CPD
3. Extrinsic factors: sedation, anxiety, anesthesia, supine position, unripe cervix, chorioamnionitis

Classification
1.Prolonged latent phase
2.Protraction disorders:1.Protracted active phase
2. Protracted descent
3.Arrest disorders:1.2ndry arrest of cervical dilatation
2. Prolonged deceleration phase
3. Arrest of descent
4. Failure of descent

Early diagnosis
1. Partogram: In active phase
Alert line: drawn from cervical dilatation on admission ,at a rate of 1 cm /h
Action line: drawn 2 h to the right of alert line (Philpott,1972).
2. Nomogram (Studd,1973):
labor stencil: a series of curves from patient admission cervical dilatation to 10 cm.
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