SEMINAR ON

DYSTOCIA, CONTRACTED
PELVIS AND CEPHALO
PELVIC DISPROPORTION

LABOR DYSTOCIA
Dystocia refers to the abnormal progress
of labor. The labor is longer, more painful
or abnormal because of problems with
the mechanics of labor, powers,
passageway, passsenger, or psyche.
Dystocia is the most common indication
for primary caesarean section,
accounting for 50% of surgical deliveries.
(Sokol etal. 1994)

Pathophysiology / etiology
1.Abnormalities of essential labor
forces
Powers
Passenger ( fetus)
Passage ( pelvis)
2. Other factors that impact the
success of the laboring patient

3. Prolonged latent phase

4. Prolonged second phase
5. Protraction disorders
6. Arrest disorders

Classification of dystocia
1.
2.
3.
4.

Pelvic dystocia
Soft tissue dystocia
Fetal dystocia
Uterine dystocia

CONTRACTED PELVIS
DEFINITION
Alteration in the size and/or
shape of the pelvis of sufficient
degree so as to alter the normal
mechanism of labor in an
average size baby.

Variations in the female pelvis

1.
2.
3.
4.

Gynaecoid pelvis
Anthropoid pelvis
Android pelvis
Platypelloid pelvis

DIAGNOSIS OF CONTRACTED PELVIS

PAST HISTORY
PHYSICAL EXAMINATION
ABDOMINAL EXAMINATION
X-RAY PELVIMETRY
CT
MRI
USG

CEPHALO PELVIC
DISPROPORTION
Disproportion in relation to pelvis, is a
state where the normal proportion
between the size of fetus to the size
of the pelvis is disturbed. The
disparity in relation between the
head and the pelvis is called cephalo
pelvic disproportion

Management of contracted
pelvis
Pre term induction of labor
Elective caesarean section
Trial labor

Obstructed labor
Obstructed labor is one where inspite
of good uterine contractions, the
progressive descent of the presenting
part is arrested due to mechanical
obstruction. This may result either due
to factors in the fetus or in the birth
canal or both, so that further progress
is almost impossible without
assistance.

Causes
1. transverse lie
2. brow presentation
3. congenital malformations
4. big baby, occipito- posterior
position
5. compound presentation
6.locked twins

Obstetrical management
Vaginal delivery
Caesarean section
Symphysiotomy

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