What are the symptoms of dystocia?

Dystocia is a situation that every pregnant friend does not want to encounter. Dystocia can cause harm to both the pregnant woman herself and the baby in her belly. There are many reasons that lead to dystocia, so pregnant women should pay more attention during pregnancy.

"Dystocia" means that when the delivery is halfway through, the fetus cannot pass through the birth canal smoothly. "Macrosomia" is indeed prone to dystocia, but dystocia is not necessarily caused by "macrosomia". There are two types of dystocia: the first is "shoulder dystocia", that is, the fetal head comes out, but the shoulders are stuck". At this time, one medical staff member can help push the mother's belly from above, and the other will help turn the fetus. However, this treatment can easily cause the child to have a clavicle fracture or strain the child's brachial plexus. The second type of dystocia is less common, that is, the mother with an abnormal fetal position tries natural delivery, but when the fetal body comes out, the fetal head is stuck. Its sequelae are the same as "shoulder dystocia", which is easy to strain the child's brachial plexus, and even skin lacerations may occur. Fortunately, this kind of fetal brachial plexus strain can be recovered through various treatments.

The definition of dystocia during maternity leave is relative to normal delivery. If a normal delivery is not possible, it is generally considered a dystocia. Caesarean section is considered a dystocia and can enjoy dystocia treatment. This also includes malposition of the fetus, including: occipital posterior position, occipital transverse position, breech position, shoulder position, etc.; there are also giant fetuses, narrow birth canal, abnormal labor force, etc. Therefore, if the delivery is not normal, it can be considered a dystocia during maternity leave.

1. Shoulder dystocia, that is, the fetal head comes out during delivery, but the shoulder is stuck and cannot be delivered. At this time, one medical staff member can help push the mother's belly from above, and the other can help turn the fetus. However, this treatment method can easily cause the child to fracture the clavicle or strain the child's brachial plexus.

2. Malposition of the fetus. This type of dystocia is relatively rare. That is, the mother with malposition of the fetus tries natural delivery, but when the fetus's body comes out, the fetal head is stuck. Its sequelae are the same as "shoulder dystocia", which is easy to strain the brachial plexus of the child and even cause skin lacerations. Fortunately, this kind of fetal brachial plexus strain can be recovered through various treatments.

You should know that when a dystocia occurs, doctors cannot perform a caesarean section on the mother, and in more than 90% of cases, the fetus cannot be pushed back. Therefore, doctors must treat each woman differently, and sometimes deliberately fracture the fetal clavicle to reduce the space occupied by the fetus's entire shoulder so that it can pass through the birth canal smoothly. Therefore, it is mentioned in the precautions for pregnancy that regular prenatal examinations are needed to keep abreast of the situation in the uterus and detect signs of dystocia in advance.

Uterine atony can be divided into primary uterine atony and secondary uterine atony.

Primary uterine atony refers to the weak and powerless uterine contractions at the beginning of labor, which last for a short time, have a long interval, and do not gradually improve with the progress of labor, but the contractions do not stop. The uterus does not bulge or harden during contractions, and most mothers do not have obvious abdominal pain. Secondary uterine atony refers to the normal uterine contractions at the beginning of labor, but when the labor progresses to a certain extent, the uterine contractions become weak. Atony can slow the expansion of the cervical opening and the descent of the fetal presenting part, prolonging or stagnating the labor process. If the labor process is too long, the mother does not rest well, eats less, and has heavy thoughts, she will be exhausted, causing intestinal bloating and difficulty urinating, which will affect uterine contractions. This vicious cycle can easily lead to dystocia, fetal distress, postpartum hemorrhage and infection.

Because of uterine atony, the labor process is prolonged, which has adverse effects on both mother and baby. Once uterine atony occurs, the doctor should comprehensively analyze the three major factors of labor force, birth canal and fetus, and make different treatments according to the different stages of labor of the parturient.

1. First stage of labor

If uterine contractions are weak, the birth canal and fetal position should be checked. If the birth canal is obstructed or the fetus is in an abnormal position, and it is estimated that vaginal delivery is not possible, cesarean section should be performed in time; if vaginal delivery is estimated, efforts should be made to strengthen uterine contractions, such as eliminating the nervousness of the parturient; if the parturient is extremely tired, sedatives can be given to allow the parturient to have enough rest and pay attention to nutritional supplements; if the parturient cannot eat, infusion can be given. If the uterine contractions still do not improve, artificial rupture of membranes can be performed. After rupture of membranes, the fetal head is close to the lower part of the uterus and the cervix, which reflexively causes uterine contractions. Uterine contractions can also be strengthened by intravenous drip of oxytocin.

2. Second stage of labor

The labor process enters the second stage, and the cervix is ​​fully dilated. At this time, the uterus is weak. If the fetus's presenting part is low and vaginal delivery is possible with assisted delivery, oxytocin can be given intravenously. Then vaginal delivery is performed to end the labor. If the fetus is large, the presenting part is high, and there is cephalopelvic disproportion, it is estimated that vaginal delivery is not possible and a cesarean section is still required.

3. The third stage of labor

After the fetus is delivered, weak uterine contractions can easily cause postpartum hemorrhage, so 10 units of oxytocin should be injected intramuscularly immediately, and abdominal massage of the uterine fundus should be performed at the same time to promote uterine contraction.