Dystocia

Finding What it may mean Why it happens Slow cervical dilation Protracted or arrested first stage Contractions may be ineffective, fetus may be malpositioned, or cervix may not respond Minimal fetal descent Passenger/passage problem Fetus may be large, malpositioned, or unable to fit through pelvis Severe back pain Occiput posterior position Fetal occiput presses against maternal sacrum Frequent painful contractions with poor progress Hypertonic dysfunction Contractions are poorly coordinated and may not create effective cervical change Weak, spaced contractions Hypotonic dysfunction Uterus lacks enough force or frequency to progress labour Maternal exhaustion Prolonged labour High energy demand, pain, dehydration, lack of rest Abnormal fetal heart rate Fetal stress or reduced oxygenation Uteroplacental perfusion may be impaired during prolonged or excessive contractions Swollen cervix/anterior lip Pushing too early or pressure from malposition Cervix becomes edematous and resists dilation Turtle sign Shoulder dystocia Shoulders are stuck after head delivery No shoulder delivery after head Shoulder dystocia emergency Anterior or posterior shoulder is impacted For REx-PN (Canada), items rarely announce the topic in the first sentence. Anchor to objective data, trajectory, and the...