异 常 分 娩 (abnormal labor)
DESCRIPTION
异 常 分 娩 (abnormal labor). 山东大学第二医院 妇产科 洪凡真 [email protected] 15098863720. 第一次妊娠剖宫产,第二次? 顺产的第一次,第二次哪次快? 臀位的都怎么生? 剖宫产横切口好,还是竖切口好? 多少周的胎儿能有较大存活的把握? 剖宫产比例怎样?. 决定分娩的四个主要因素 ?. 决定分娩的四个主要因素产力、产道、胎儿及精神心理因素中,出现任何一个或一个以上因素异常,使产程进展异常及分娩受阻,产程延长甚至停顿而需手术助产,称为异常分娩(简称难产, dystocia ). 本章主要讲述. - PowerPoint PPT PresentationTRANSCRIPT
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(abnormal labor) [email protected]
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?
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dystocia
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abnormal uterine action
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,
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(uterine atony) hypotonic uterine atony hypertonic uterine atony
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()
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100mg.
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20mmHg),30s5-6min60s1-2min.
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(prolonged latent phase) 16h(8h)8h(prolonged active phase) 8(4h)1.2cm/h,1.5cm/h protracted active phase) 2h
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prolonged descent)lcm/h2cm/hprotracted descent)lhprolonged second stage) 2h1h protracted second stage) 1h(prolonged labor) 24h
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6
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Bishop
Bishop(1964Pelvic scoring of elective induction Obstet Gynecol )33465079809
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Bishop Scoring System
Score
Dilation(cm)
Effacement(%)
Station
Consistency
Position of Cervix
0
Closed
0-30
-3
Firm
Posterior
1
1-2
40-50
-2
Medium
Midposition
2
3-4
60-70
-1,0
Soft
Anterior
3
>/=5
>/=80
+1,+2
From Intrapartum Obstetrics
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4cm,2cm, 2.5U4-5/
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PGs) 10mg 10mg
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(vacuum extraction)(forceps delivery)
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100mg
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tetanic contraction of uterus) (constriction ring of uterus)
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3h(precipitate delivery)
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K1
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2520ml5-10%20ml
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Question
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contracted pelvis)
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18cm16.5~17.5cm16cm11.5cm10~11cm9.5cm10cm8.5~9.5cm8cm
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10cm8.5~9.5cm8.0cm7.5cm6.0~7.0cm5.5cm
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2cm
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VitD
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1cm
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,
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2~4
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15cm15cm
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Question
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Next class
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90106%7%(breech presentation) 3%4(fetal lie)(shoulder presentation) (compound presentation)
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(persistent occiput posterior positionpersistent occiput transverse position) 13590
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, 13545
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1.
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2.
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3.4.
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1cm/h
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(sincipital presentation)occipito-pubic position)occipito-sacral position)
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(anterior asynelitism)posterior asynelitism)
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face presentation),
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Breech presentation
3%-4%()
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(left sacro-anterior,LSA)(left sacro-transverse,LST)(left sacro-posterior LSP)6
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30
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Incomplete breech presentationComplete breech presentation Frank breech presentation
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1. 2. 3.4.
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180
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303036-37
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3500g
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4cm
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3 8
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K
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MSV
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shoulder presentation),
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fetal macrosomia) 4000gshoulder dystocia)
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>10.0cmAC>HC2cmGDM