Dysfunctional Labor, Uterine Contractility, and Dystocia Flashcards
Maximal dilation and descent for a nulliparous woman?
- 1.2 cm/hr
- 1.0 cm/hr
Maximal dilation and descent for Multiparous woman?
- 1.5 cm/hr
- 2.0 cm/hr
If we are in the active phase of labor, how do we differentiate between a protraction disorder and arrest of dilation?
- if cervical dilation is less than norms: protraction
- if 2 or more hours elapse with no cervical dilation: arrest of dilation
- same principle applies for fetal descent
What are the three P’s of the active phase?
- Passage
- Passenger
- Power
When should the diagnosis of dystocia NOT be made?
-before an adequate trial of labor has been tried
When should we augment?
-if contractions are less than 3 in a 10 minute period
What can cause an abnormality of the Passage part of the active phase?
-Cephalopelvic disproportion (CPD)
Which types of pelvises do well with labor?
-gynecoid and anthropoid
What will ladies that are delivering with OP position have as a symptom?
-back discomfort
Define macrosomia
-4500 gms or more
What is the main risk associated with macrosomia?
- damage to th nerves of the brachial plexus
- even though those are rare and usually resolve without any permanent injury *
What is it called when there is a brachial plexus injury?
- erb-Duschenne palsy
- damage to C5 and C6 nerves
Klumpke palsy
- lower arm palsy
- damage to C8 and T1
When does ACOG recommend a prophylactic c section in diabetic and non diabetic women?
- diabetic: 4,500
- non: 5,000
What is the turtle sign associated with?
-shoulder dystocia
