How to differentiate dystocia?

How to diagnose and identify dystocia? If dystocia can be discovered in time, the mode of delivery can be changed. However, if the time for timely treatment is missed, it may cause life-threatening danger to both the mother and the fetus. Therefore, the diagnosis and identification of dystocia is very important. So how to diagnose and identify dystocia?

1. When false labor occurs with uterine contractions, it should be differentiated from coordinated uterine atony. The characteristics of false labor are that pregnant women have no conscious symptoms, or only mild backache or downward abdominal pain, irregular uterine contractions, duration less than 30 seconds, long and irregular intervals, and no gradual increase in the intensity of uterine contractions. Uterine contractions often occur at night and gradually weaken or disappear in the early morning. The cervix does not gradually expand with the contractions. Most vaginas do not have bloody secretions. After intramuscular injection of strong sedatives such as pethidine, irregular uterine contractions disappear. For those with coordinated uterine atony, after intramuscular injection of pethidine and the mother rests quietly for a period of time, the uterine contractions gradually increase, become regular and coordinated, and the cervix gradually opens.

2. Uncoordinated uterine atony should be differentiated from coordinated uterine atony.

3. Coordinated uterine atony.

4. Grade II placental abruption has persistent abdominal pain, backache or back pain, tight uterine contractions, which should be differentiated from coordinated uterine contraction weakness. However, this disease often has a history of trauma and hypertension, the uterus is continuously contracted, like a hard board, tenderness, and signs of fetal distress. If it is grade III placental abruption, symptoms of hemorrhagic shock appear, the fetal heart rate cannot be heard clearly, the fetal position cannot be palpated, and the fetus dies in utero. B-type ultrasound examination shows retroplacental hematoma, which is easy to identify.

5. Coordinated uterine contraction is too strong. Coordinated uterine contraction should be distinguished from uncoordinated uterine contraction. However, the uterine contraction during coordinated uterine contraction is still rhythmic, symmetrical and polar. The cervix expands rapidly. If the fetus is delivered without resistance, premature delivery is likely to occur.

6. The tonic uterine contractions caused by intravenous infusion of oxytocin are mostly uncoordinated uterine contractions, which are common in those who use oxytocin to induce labor. After stopping the infusion of oxytocin, the uterine contractions gradually weaken or even disappear. After rupture of membranes, the uterine contractions gradually become coordinated.

7. Differences between uterine spasmodic stricture ring and uterine pathological contraction ring

(1) The causes are mostly premature rupture of membranes, inappropriate use of uterotonics, intrauterine manipulation and psychological factors.

(2) It can occur in the first, second, or third stage of labor, such as placenta incarceration during the third stage of labor.

(3) Good maternal and fetal outcomes.

(4) The ring is located in a thinner part of the fetus.

(5) Abdominal palpation is generally normal, and only during intrauterine examination can a ring-shaped bulge be found.

(6) The lower uterine segment below the ring is not stretched or thinned and there is no tenderness.

(7) The uterine body does not thicken and tonic uterine contractions do not occur.

(8) The presenting part of the fetus is not necessarily in the pelvis, nor is it squeezed against the cervix and tightly wrapped by the cervix. The fetal head is not obviously deformed. When the uterus contracts, the fetal head descends, the cervix does not expand, and the cervix may even become soft and droopy like a cuff.

(9) The round ligament is not tight and tender.

(10) Uterine rupture generally does not occur.