What is a “Bandl’s Ring” or Retraction
Ring? much thicker above than below the
- occurs at the
junction of the upper and lower uterine
segments. The Ring usually appears
at the 2nd stage of labor as a
horizontal indentation across the
abdomen and is a warning sign that a
dysfunctional labor is occurring; it is
formed by excessive retraction of the
upper uterine segment.
-A Constriction of the
junction between the thinned lower
uterine segment and the thick
retracted upper uterine segment
caused by obstructed labor; a sign of
impending rupture of the uterus.
Why does this occur?
There are two types of uterine
muscles, one to help the cervix dilate
and the other to help push the baby
out. At their juncture, rarely (usually
during a prolonged and/or obstructed
labor) a ring develops around a
“depression” in the fetus, usually over
the neck. It is formed by excessive
retraction of the upper uterine
segment; the uterine myometrium is
care for caesarean sections
ring. And then the Uterus tries to
compensate by increasing in tone and
intensity & frequency of contractions.
As a result, the lower uterine segment
lengthens and thins, and becomes
tender. Upper segment becomes hard
and thick, and progressively retracts.
Sometimes when this happens, even
a birth by C-section is difficult,
because the ring prevents the birth of
the shoulders and the rest of the body.
Usually, the uterus will greatly
constrict, which disrupts placental
blood flow, and therefore oxygen flow,
to the fetus.
What are the Contributing Factors?
 An abnormality in a mother’s pelvis
(a contracted pelvis).
 Fetal causes (hydrocephalus, fetal
ascitis, sacrococcygeal tumours,
conjoined twins
 Cephalopelvic disproportion
 Previous caesarean section, still
births and previous prolonged
labor.
 Delay in referral to higher level of
 Abnormal presentations and
position
What are the Maternal Risks?
 Puerperal sepsis
 rupture of the lower segment,
 maternal hemorrhage
 maternal exhaustion, inertia, and
arrest of contractions
 maternal fistula, lacerations
What are the fetal Risks?
 Asphyxia
 Intracranial hemorrhage
 Delayed complications—delayed
milestones, convulsive disorders,
mental retardation etc.
 placental abruption
 uteroplacental insufficiency with
resultant fetal hypoxia and
distress.
 still births and neonatal death
Retraction Ring
Members:
Busa, Ana Marie
Nodalo, Evelyn
Tan, Louie
Ymas, Christine