Dystocia

Dystocia means difficult, slow, abnormal, or obstructed labour. For RPN-level maternity nursing, dystocia should be understood as a problem with the normal progress of labour, delivery of the fetus, or delivery of the shoulders. It is not one single diagnosis. It is an umbrella term that can include prolonged labour, arrest of dilation, arrest of descent, malposition, cephalopelvic disproportion, ineffective contractions, and shoulder dystocia. The safest way to understand dystocia is through the classic framework of the 3 Ps: Factor Meaning How it causes dystocia Power Uterine contractions and maternal pushing effort Contractions may be too weak, too infrequent, too strong, uncoordinated, or poorly effective Passenger The fetus The fetus may be too large, malpositioned, malpresenting, or unable to descend properly Passage Maternal pelvis and soft tissues The pelvis may be small, the fetal head may not fit well, or soft-tissue obstruction may slow progress Modern labour guidance recognizes that labour progress varies, especially in the latent phase. Slow labour does not automatically mean emergency delivery. However, dystocia becomes dangerous when there is no cervical change, no fetal descent, fetal...