簡介:ABNORMALLABORANDDELIVERYDYSTOCIA,,LABORANDDELIVERY,UTERINECONTRACTIONSTHATCAUSEPROGRESSIVEEFFACEMENTOFCERVIXANDDILATIONDESCENTOFFETUSEXPULSIONOFFETUSANDPLACENTA,THEFOURFACTORSFORLABOR,FORCECONTRACTIONBIRTHCANALBONYCANALFETUSLIE,POSITION,PRESENTATION,WEIGHT,MALFORMATIONPSYCHICALFACTORS,CAUSESOFDYSTOCIA,ABNORMALUTERINEACTIONPOWERABNORMALPELVISPASSAGESABNORMALPASSENGERINFANTSIZEANDFETALPRESENTATION,ABNORMALPSYCHICALFACTORS,,1ABNORMALUTERINEACTIONPOWERABNORMALITIESOFTHEEXPULSIVEFORCESEITHERUTERINEFORCESINSUFFICIENTLYSTRONGTOEFFACEANDDILATETHECERVIXUTERINEDYSFUNCTIONINADEQUATEVOLUNTARYMUSCLEEFFORTDURINGTHESECONDSTAGE,,,COMMONCLINICALFINDINGSINWOMENWITHINEFFECTIVELABORINADEQUATECERVICALDILATIONORFETALDESCENTPROTRACTEDLABORSLOWPROGRESSARRESTEDLABORNOPROGRESSINADEQUATEEXPULSIVEEFFORTINEFFECTIVE“PUSHING”,,DIAGNOSTICCRITERIAFORABNORMALPATTERNSINACTIVELABOR,VALUESREPRESENTAPPROXIMATELYTWOSTANDARDDEVIATIONSFROMTHEMEAN,STAGESOFNORMALLABOR,THEFIRSTSTAGEONSETOFLABORTOFULLCERVICALDILATION10CMTHELATENTPHASEONESTTO3CMTO10CM,8HTHESECONDSTAGE10CMTOTHEDELIVERYOFTHEINFANT,2HTHETHIRDSTAGEDELIVERYOFTHEINFANTTODELIVERYOFTHEPLACENTA,30M’THEFOURTHSTAGE2HOURSAFTERDELIVERYOFTHEPLACENTA,,DIVIDES1STSTAGEINTOLATENTANDACTIVEPHASEPROLONGEDLATENTPHASE潛伏期延長)DEFINEDASGREATERTHAN16HOURSINANULLIPARAANDGREATERTHAN14HOURSINAPAROUSWOMAN,ACTIVEPHASE(活躍期)DISORDERSPROTRACTION(延長)SLOWRATEOFCERVICALDILATIONORDESCENTFORNULLIPARAS12CMDILATATION/HROR1CMDESCENT/HRFORMULTIPARAS15CMDILATATION/HROR2CMDESCENT/HRTREATWITHEXPECTANTMANAGEMENT/OXYTOCINARREST(停滯)COMPLETECESSATIONOFDILATATIONORDESCENTARRESTOFDILATATION2HOURSWITHNOCERVICALCHANGEARRESTOFDESCENT1HOURWITHOUTFETALDESCENT,SECONDSTAGEBEGINSWHENCERVICALDILATIONISCOMPLETEANDENDSWITHEXPULSIONOFFETUSUNTILRECENTLY,LIMITEDTO2HOURSWITHOUTEPIDURALANDTO3HOURSWITHEPIDURALUNTILRECENTLY,LIMITEDTO1HOURWITHOUTANEPIDURALANDTO2HOURSWITHANEPIDURALCANBELONGERWITHBIGGERBABIESANDREGIONALANESTHESIA,,,MANAGEMENT,POORPROGRESSIONINTHEFIRSTSTAGEHYPOCONTRACTILEUTERINEACTIVITYISTREATEDWITHOXYTOCIN,WHICHISTHEONLYMEDICATIONAPPROVEDBYTHEUSFOODANDDRUGADMINISTRATIONFDAFORLABORSTIMULATIONINTHEACTIVEPHASE,導樂和陪伴,MANAGEMENT,OTHEROTHERINTERVENTIONS,AMBULATIONRUPTUREOFMEMBRANCEOTHERMEDICINES,MANAGEMENT,HYPOTONICDYSFUNCTIONINSUFFICIENTIRREGULARINFREQUENTRESPONSEWELLTOOXYTOCINMOSTINPRIMIGRAVIDASINACTIVEPHASEHYPERTONICANDUNCOORDINATEDDYSFUNCTIONRESTINGTONEDYS-SYNCHRONOUSFREQUENTINTENSECONTRACTIONCONSTRICTIONRINGTOCOLYSISDECREASEOXYTOCINCESAREANSECTIONSEDATION,MANAGEMENT,POORPROGRESSIONINTHESECONDSTAGETHREEOPTIONSCONTINUEDOBSERVATIONATTEMPTATOPERATIVEVAGINALDELIVERYCESAREANDELIVERY,FORCEPSDELIVERY,FORCEPS,VACUUM,VACUUM,CESAREANSECTION,,2ABNORMALPELVISPASSAGESABNORMALITIESOFTHEMATERNALBONYPELVISINLETMIDPELVICOUTLETGENERALLYCONTRACTEDPELVICDEFORMEDPELVICSOFTTISSUEOBSTRUCTIONCONGENITALANOMALIESSCARRINGOFBIRTHCANALPELVICMASSESABNORMALPLACENTALOCATION,THEPASSAGESTHEPELVIS,,PELVICINLETAP115CMTRANSVERSELY136CMMIDCAVITYALLDIAMETERS12CMPELVICOUTLETAP125CMTRANSVERELY105CM,THEPASSAGESTHEPELVIS,THECLINICIANSABILITYTOPREDICTMATERNALPELVISFETALSIZEDISCORDANCECEPHALOPELVICDISPROPORTIONLEADINGTOARRESTOFLABORREQUIRINGCESAREANDELIVERYHASBEENDISAPPOINTING,CLINICALORRADIOLOGICASSESSMENTOFTHEMATERNALPELVISIE,PELVIMETRYISASSOCIATEDWITHPOORPREDICTIVEVALUE,THEPASSAGESTHEPELVIS,,3ABNORMALITIESOFTHEPASSENGERMALPOSITIONANDMALPRESENTATIONFETALMACROSOMIA≥4000GSHOULDERDYSTOCIAFETALMALFORMATION,PASSENGER,,FLEXEDHEAD,GOOD,,NEUTRAL,OK,,DEFLEXED,,ANTERIORFONTANEL,,POSTERIORFONTANEL,,OA,,OP,,OCCIPUTPOSTERIOR,,ROA,,LOA,,ROT,,LOT,,LOP,,LOP,,TRANSLIE,,TRANSVERSELIE,,,,BREECH,BREECH,,BREECH,,COMPOUNDPRECENTATIONB,,PASSENGERFACEPRESENTATION,,,,CESAREANSECTION,WHOTARGETC/SRATEIS1015C/SRATEISABOUT50INCHINADYSTOCIAISMOSTCOMMONREASONFORPRIMARYC/S,PSYCHICALFACTORS,DOULA(導樂)LABORANALGESIA(分娩鎮(zhèn)痛),KEYWORDS,PROLONGEDLATENTPHASEACTIVEPHASEPROTRACTION,ARRESTPROLONGEDLABORPRECIPITATEDELIVERYCONSTRICTIONRINGOFUTERUSCONTRACTEDPELVIC,
下載積分: 4 賞幣
上傳時間:2024-01-06
頁數(shù): 57
大?。?4.39(MB)
子文件數(shù):