dysfunctional-labour

dysfunctional-labour - Failure to progress Benha University...

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Failure to progress Benha University Hospital, Egypt Email: elnashar53@hotmail.com
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Stages of labor Stage I Latent phase Active phase: . A cceleration . Maximum slope . Deceleration Stage II Phase 1 Phase 2 Stage III Stage IV
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0 2 4 6 8 10 12 2 4 6 8 10 12 14 16 Latent phase Active phase 2nd stage 1st stage max slope acceleration dec Time (hours) Cervical dilatation (cm) Friedman labor curve in nulliparous
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Labor duration (Friedman,1978) Variable Nulliparas (h) Multiparas(h) Latent phase mean 6.4 4.8 upper limit 20.1 13.6 Active phase mean 4.6 2.4 dilatation rate(cm/h) 1.2 1.5 Second stage mean 1 0.5 upper limit 2.9 1.1
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Dysfunctional labor Definition Any deviation in normal progress of labor , either in cervical dilatation or in descent of the presenting part
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Etiology 1. Malfunction in the myogenic, neurogenic, or hormonal mechanisms of uterine activity. 2. Malpresentation, fetal anomalies, uterine malformation, pelvic tumors, overdistension of the uterus, CPD 3. Extrinsic factors : sedation, anxiety, anesthesia, supine position, unripe cervix, chorioamnionitis
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Classification Freidman (1989) : 1. Prolonged latent phase 2. Protraction disorders :1.Protracted active phase 2. Protracted descent 3. Arrest disorders: 1.2ndry arrest of cervical dilatation 2. Prolonged deceleration phase 3. Arrest of descent 4. Failure of descent
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ACOG (1995): 1. Protraction disorders Slower than normal 2. Arrest disorders Complete cessation of progress
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Fields 1.Hypotonic dysfunction a.Prolonged latent phase b.Prolonged active phase c. Prolonged deceleration phase d. Prolonged 2 nd stage 2.Hypertonic dysfunction
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1.Disorders of dilatation: a. Prolonged latent phase b. Protracted active phase c. Secondary arrest 2.Disorders of descent: a. Failure of descent b. Protracted descent
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Philpott (1979) 1. Prolonged latent phase 2. Primary dysfunctional labor 3. 2ndry arrest of labor.
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dysfunctional-labour - Failure to progress Benha University...

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