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Dystocia can result from several distinct abnormalities involving the cervix,
uterus, fetus, abnormal bony pelvis, or other obstruction in the birth canal.
These abnormalities have been mechanistically simplified by the American
College of Obstetrics and Gynecologist in to three categories:
1. Abnormalities of the power (uterine contractility, and maternal
expulsive effort)
2. Abnormalities involving the passenger (the fetus)
3. Abnormalities of the passage (the pelvis).
Uterine dysfunction
1. Hypertonic uterine dysfunction, there is no basal hypertonus and
uterine contractions have a normal gradient pattern (synchronous),
but the slight rise in pressure during a contraction is insufficient to
dilate the cervix.
Self assessment:
1.
2.
3.
4.
Learning
outcome
Learning objective
PIC
Manage, establish
tentative
diagnosis, provide
initial
management,
and/or refer
patient with
dystocia
Abnormal labor
Comprehend the
abnormal labor and
fetopelvic
disproportion.
Comprehend the
abnormal
presentation, position,
and development of
the fetus.
Apply basic principles
of special
investigation on
patient with abnormal
labor
Recognize clinically,
provide initial
management, refer,
with abnormal labnor.
dr.Tjokord
a Gde
Agung
Suwardew
a,
SpOG(K)
Student
reference
s
William,
21st
425-466
Day