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Understanding the Warning Signal of the Uterus and the Fetus
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Malformations: Cephalic presentation with hydrocephalous needs vigilance for disproportion. An intervention by tapping of the head to reduce the engaging diameters may be required when there is dystocia. This should be done after counselling and weighing the prognosis of the condition and salvageability of the fetus. Hydrocephalous presenting as breech needs vigilance in the second stage for tapping through the foramen magnum to aid in the delivery of the large head. Other malformations such as sacrococcygeal teratoma, soft tissue problems such as massive fetal ascites, abdominal tumours, and conjoined twins can also cause serious dystocia late in labour.
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Uterine rupture is when the muscular wall of the uterus tears during pregnancy or childbirth. Risk factors are prolonged labour, dystocia, grand multiparity, previous caesarean section, previous myomectomy and excessive amounts of uterotonics.
Shoulder dystocia
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Randall C. Floyd, James S. Smeltzer
This situation can be made worse by ignorance and panic. The parturient wants to push the baby out, perhaps with the “help” from others by fundal pressure, further wedging the shoulders at the inlet. Attempting to push the anterior shoulder through the inlet with suprapubic pressure would further impact the posterior shoulder. The inclination of the novice accoucheur is to overcome the impaction by force, pulling the fetal head posteriorly, which stretches the brachial plexus of the anterior arm, or inferiorly, which further stretches the plexus of the posterior arm. The fetus is lucky if dystocia is mild or the obstruction is overcome by the fracture of a clavicle, either spontaneously or by the use of suprapubic pressure. The inclination to use suprapubic pressure is reinforced by many articles and texts on shoulder dystocia. It is usually ineffective in high dystocia (10) and should not be used until it is verified that the posterior shoulder is in the pelvis or in an attempt to fracture the clavicle. Once the posterior shoulder is definitely in the pelvis, suprapubic pressure becomes rational, indicated, and likely to work.
Intrauterine device penetrating the anterior urinary bladder wall discovered during caesarean section: a case report
Published in Journal of Obstetrics and Gynaecology, 2020
Goda Jievaltienė, Dominyka Surgontaitė, Rosita Aniulienė, Donatas Venskutonis
This report describes a case when during a caesarean section (C-section) an IUD was found stuck in the anterior wall of a 41-year-old woman’s urinary bladder. The patient, gravida 2, 40 weeks pregnant arrived at the hospital with irregular uterine contractions and lower abdominal pain. During the general examination, class III obesity was diagnosed. As the labour progressed, it was decided to perform an urgent C-section due to dystocia caused by the pelvis and foetus disproportion. During the operation, a copper IUD was found penetrating the anterior wall of the urinary bladder (Figure 1). No additional scarring was visible on the uterine wall. After successful IUD removal, the urinary bladder wound was closed with separated two layer sutures. A girl, weighing 4435 g, was born. The patient and the newborn were stable, no complications occurred. The woman’s urinary bladder was catheterised for a week using Foley’s self-retaining catheter. Lactational amenorrhoea and its contraceptive effect were explained, further use of desogestrel was recommended. The patient stated that she would only use barrier contraceptive methods.
Analysing the likelihood of caesarean birth after implementation of the two-childbirth policy in China, using the Ten Group Classification System
Published in Journal of Obstetrics and Gynaecology, 2020
Jie Wen, QinQing Chen, Qiong Luo
Caesarean section is the most common surgical procedure and can be lifesaving when performed to address certain types of dystocia and other complications. On the other hand, there is growing concern about the increased incidence of long-term complications among women who receive a Caesarean section, including a menstrual disorder, Caesarean scar pregnancy, placenta previa and placenta implantation abnormality (Blustein and Liu 2015). According to the World Health Organization Human Reproduction Programme (2015), Caesarean birth rates should not exceed 10–15%. However, the rates of Caesarean birth are rising both worldwide and in Asian countries. In China, the Caesarean section rate has increased dramatically, with the overall rate increasing from 3.4% in 1988 to 34.9% in 2014 (Feng et al. 2012; Li et al. 2017).
The relationship between Cormic Index and uterine contractions’ pattern in the active phase of the first stage of labour
Published in Journal of Obstetrics and Gynaecology, 2020
Maryam Pourshirazi, Nahid Golmakani, Samira Ebrahimzadeh Zagami, Habibollah Esmaily, Fateme Tara
Altahus et al. (2006) investigated the fact that whether or not special shapes of contractions (sudden ascending and its slow return to baseline) during the labour will predict cephalopelvic disproportion. This study was carried out on 100 women who had a spontaneous vaginal labour, comparing with 100 women who underwent a caesarean section due to CPD or arrested labour. Contractions were recorded in the active phase of labour using tocodynomometer for an hour. The F:R ratio for each contraction and a total F:R for each woman were obtained. The average was then determined for all the contractions in one hour. The study showed that dystocia due to cephalopelvic disproportion is correlated with a special uterine activity pattern in which the descending time of contraction becomes prolonged.