Central to the management of dystocia is augmentation of labor, that is, correcting ineffective uterine contractions. Despite vast experience with labor. 49, December Dystocia and Augmentation of Labor. First published: 12 May (04) Cited by: 4. About. diagnosis and management of dystocia, including a range of acceptable methods of augmentation of labor. Normal labor. Labor commences when uterine.

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Cervidil is a vaginal insert containing 10 mg of dinoprostone in a timed-release formulation. The likelihood of a vaginal delivery after labor induction is. Induction of labor with oxytocin. The guideline includes the following clinical considerations and recommendations: Shoulder dystocia is a medical and possibly surgical emergency.

Active genital herpes infection. The posterior arm is identified and followed to the elbow. The head is then flexed and pushed back into the vagina, followed abdominal delivery.

ACOG Practice Bulletin Number 49, December 2003: Dystocia and augmentation of labor.

An uninflated Foley catheter can be passed through an undilated cervix and then inflated. Membrane stripping is a widely utilized technique, which causes release of either prostaglandin F2-alpha from the decidua and adjacent membranes or prostaglandin E2 from the cervix.

A prolonged latent phase is one that exceeds 20 hours in the nullipara or one that exceeds 14 hours in the multipara. Clinical evaluation of postpartum hemorrhage.

Dystocia and Augmentation of Labor

Beta-blockers are generally considered to be safe, although they may impair fetal growth when used early in pregnancy, particularly atenolol. First stage of labor 1. Conditions associated with bleeding from coagulopathy and thrombocytopenia include abruptio placentae, amniotic fluid embolism, preeclampsia, coagulation disorders, autoimmune thrombocytopenia, and anticoagulants.

In the report, ACOG lists parameters for defining when labor becomes prolonged and intervention should be considered. The Rubin maneuver is the reverse of Woods’s maneuver. Want to use this article elsewhere? Uterine rupture is associated with previous uterine surgery, internal podalic version, breech extraction, multiple gestation, and abnormal fetal presentation. See My Options close Already a member or subscriber? Amniotomy is an effective method of labor induction when performed in women with partially dilated and effaced cervices.


Continuous support during labor from caregivers nurses, midwives, or lay persons has several benefits to the patients and newborns without any evidence of harmful effects. This stage is divided into the latent phase and the active phase. Additional measures may include changing the patient to the lateral decubitus position and administering oxygen or more intravenous fluid.

A maximum of 5 contractions in a minute period with resultant cervical dilatation is considered adequate. The first stage of labor consists of the period from the onset of labor until complete cervical dilation 10 cm.

To see the full article, log in or purchase access. Absolute contraindications to labor induction: The incidence varies from 0.

Dystocia and Augmentation of Labor

A pelvic examination should be performed before initiation of oxytocin infusion. Current data do not support the theory that low-dose oxytocin regimens are superior to high-dose regimens for augmentation of labor. No data indicate the optimal frequency for intermittent auscultation in the absence of risk factors. Labor abnormalities due to the pelvic passage passage 1.

Indications for labor induction: Continue reading from March 1, Dystociq If cephalic replacement fails, an emergency symphysiotomy should be performed.

The report provides a review of the definition of dystocia, the risk factors associated with dystocia, the criteria that require delivery, and the approaches to clinical management of labor complicated by dystocia.


Not enough evidence is available to support the use of x-ray pelvimetry in patients whose fetuses have cephalic presentations. A baseline ultrasound examination is recommended at 16 to 20 weeks of gestation to confirm gestational age. Begin oxytocin 6 mU per minute intravenously Dhstocia dose by 6 mU per minute every 15 minutes Maximum dose: An assistant is requested dyystocia apply pressure downward, above the symphysis pubis.

Labor dystociia caused by fetal characteristics passenger 1. Occiput posterior fetal position.

Oxytocin is usually diluted 10 units in 1 liter of normal saline IVPB. Sodium restriction and diuretics have no role in therapy. The time interval between the final dose and initiation of oxytocin should be 6 to 12 hours because of the potential for uterine hyperstimulation with concurrent oxytocin and prostaglandin administration. Obstetric hemorrhage remains a leading causes of maternal mortality. Cervical and vaginal lavage after local application of prostaglandin compounds is not helpful.

High-dose regimens o be used for multiparous women, but no data support the use of high-dose oxytocin regimens for augmentation in a patient with a previously scarred uterus. Short stature less than 5 ft [ cm]. A nonstress test or biophysical profile should be performed weekly starting at 32 weeks.

Prostaglandin E2 PGE2 preparations have up to a 5 percent rate of uterine hyperstimulation. Postpartum hemorrhage is defined as the loss of more than mL of dystodia following delivery. Walking during labor has not been shown to enhance or impair progress in labor.

Induction of labor refers to stimulation of uterine contractions prior to the onset of spontaneous labor.