6 abnormal labor and dystocia
TRANSCRIPT
Abnormal labor and Dystocia
Dept of ObampGyn The first affiliated hospital
He Ke
Definition
Difficult labor or childbirth
Abnormal slow progress
of labor
Incidence
The most common
indication for primary
cesarean section
Abnormal patterns
Prolonged latent phase
Protraction disorders (active phase)
Arrest disorders (active phase)
Precipitate labor disorders
Evaluation index
Cervical dilation
Descent of the fetal presentation
Friedmanrsquos curve
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Definition
Difficult labor or childbirth
Abnormal slow progress
of labor
Incidence
The most common
indication for primary
cesarean section
Abnormal patterns
Prolonged latent phase
Protraction disorders (active phase)
Arrest disorders (active phase)
Precipitate labor disorders
Evaluation index
Cervical dilation
Descent of the fetal presentation
Friedmanrsquos curve
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Incidence
The most common
indication for primary
cesarean section
Abnormal patterns
Prolonged latent phase
Protraction disorders (active phase)
Arrest disorders (active phase)
Precipitate labor disorders
Evaluation index
Cervical dilation
Descent of the fetal presentation
Friedmanrsquos curve
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Abnormal patterns
Prolonged latent phase
Protraction disorders (active phase)
Arrest disorders (active phase)
Precipitate labor disorders
Evaluation index
Cervical dilation
Descent of the fetal presentation
Friedmanrsquos curve
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Evaluation index
Cervical dilation
Descent of the fetal presentation
Friedmanrsquos curve
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Friedmanrsquos curve
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Latent phase
Active phaseI II stage
产程图partogram
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Prolonged latent phase
1048698 Nulliparas
Multiparas
prolonged
gt20 hr
gt 14 hr
Normal average
64 hr
48 hr
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Protraction disorders
1048698 Nulliparas
Multiparas
Descent
lt10 cmh
lt20 cmh
Dilation
lt12 cmh
lt15 cmh
Average
8hr
5hr
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Arrest disorder
1048698 Nulliparas
Multiparas
Descent
gt2h
gt1h
Dilation
gt2h
gt1h
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Partogram
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
A 潜伏期延长 prolonged latent phaseB 活跃期延长 prolonged active phaseC 活跃期停滞 arrest active phase
Abnormal partogram
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Partogram
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Precipitate labor disorders
1048698 Nulliparas
Multiparas
Descent
gt5cmhr
gt10cmhr
Dilation
gt5cmhr
gt10cmhr
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Classification of Dystocia
Abnormalities of the Power
Abnormalities of the Passage
Abnormalities of the Passenger
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Characteristics of the power
Intensity is greater in the fundus Average 24mmHg Well synchronized Frequency Duration 60s regular Rhythm and force Basal resting pressure 12-15mmHg
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Fetal monitoring
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
External and internal monitor
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Uterine dysfunction
Hypotonic
Hypertonic
Uncoordinated
Inadequate
expulsive efforts
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Hypotonic dysfunction
Insufficient
Irregular
Infrequent
Response well to
oxytocin
Most in primigravidas
in active phase
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Hypotonic dysfunction etiology
Malfunction
Malpresentation
Extrinsic factors
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Hypertonic and uncoordinated dysfunction
Resting tone
Dyssynchronous
Frequent intense contracti
on
Constriction ring
Tocolysis
Decrease oxytocin
Cesarean section
Sedation
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Pathological retraction ring
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Constriction ring
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Hypertonic Dysfunction
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Inadequate expulsive efforts
Second stage
Assisted delivery might be needed
Analgesic anesthetic agents wear
off
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Abnormalities of the Passage
Bony pelvic (most common)
Soft tissue obstruction
Abnormal placenta location
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Bony pelvic abnormalities
Inlet
Midpelvic-outlet
Generally contracted pelvic
Deformed pelvic
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Three level of bony pelvis
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Contracted pelvis
Contraction of pelvic inlet
APlt10cmtransverselt12 cm Contraction of mid-pelvis
interischial spinous diameter lt10cm Contraction of pelvic outlet
interischial tuberous diameter lt8cm
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Three anteroposterior diameters of the pelvic inlet
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Diameter of the inlet and midpelvis
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Fetopelvic disproportion
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
正常骨盆 入口呈心型 出口呈漏斗型funnel shaped pelvis
473 58
366109
gynecoidandroid
Flat(platypelloid) anthropoid
前后径狭 窄
横径 狭窄transversely
contracted
pelvis
女性男性
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
each pelvic plane is 2 cm less than normal
均小骨盆 generally contracted pelvis
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
osteomalacia oblique pelvis
kyphosis
成人
行走之前 行走之后
Deformed pelvis
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Soft tissue dystocia
Congenital anomalies
Scarring of birth canal
Pelvic masses
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Birth canal
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Pelvic mass
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Pelvic mass
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Low ndashlying placenta
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Abnormalities of the Passenger
Malposition and malpr
esentation
Fetal macrosomia
Shoulder dystocia
Fetal malformation
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
133
95
113
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Cepholic position and the diameter through pelvis
occiput
presentation
parietal
presentation
brow
presentation
face
presentation
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Malpresentation
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Breech presentation
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Transverse fetal lie
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Shoulder presentation
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Examination
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Fetal macrosomialarge for gestational age(LGA) ge4000
g
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Shoulder dystocia
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Brachial Plexus Injury
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Fetal malformation
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Operative delivery
1)forceps
operations
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Operative delivery Vacuum
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Operative delivery Cesarean Section
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)
Reference Williams obstetrics
(22nd edition)High risk pregnancy (2nd edition)