A protracted course of labor is an unusually slow cervical dilatation or a delayed descent of the child during active labor. The diagnosis is made clinically. Treatment is with oxytocin, operative vaginal delivery or caesarean section.

An intensive labor generally begins when the cervix is ??dilated to ? 4 cm. Normally, short of cervical dilatation and descent of the fetal head into the pelvis by at least 1 cm / hour, with multiparas even faster.

A protracted course of labor is an unusually slow cervical dilatation or a delayed descent of the child during active labor. The diagnosis is made clinically. Treatment is with oxytocin, operative vaginal delivery or caesarean section. An intensive labor generally begins when the cervix is ??dilated to ? 4 cm. Normally, short of cervical dilatation and descent of the fetal head into the pelvis by at least 1 cm / hour, with multiparas even faster. Etiology A protracted calving may consist of a relative disparity between the fetus and the maternal pelvis result (the fetus can not pass through the maternal pelvis). This can occur because either the maternal pelvis or because the fetus is unusually narrow unusually large or is in an irregular situation (fetal birth disorder). Another cause of protracted labor are too weak or rare contractions (hypotonic uterine dysfunction, uterine inertia) or occasionally too strong or too frequent contractions (hypertonic uterine dysfunction, labor Sturm). Diagnostic assessment of the extent of the basin, fetal size and location and the uterine contractions Frequent therapeutic success The diagnosis of protracted labor is clinical. The cause must be found, because the treatment is based on it. to determine the extent of the child and the child’s pelvis and location (physical examination) may reveal in some cases, whether the cause is a relative mismatch. For example, a fetal weight> 5000 g suggests a mismatch between fetus and pelvis (> 4500 g in diabetic women). A uterine dysfunction is diagnosed by the strength and frequency of the contractions by palpation of the uterus or by means of application of an intrauterine pressure catheter be assessed. Often, the diagnosis from the reaction yields to therapy. Treatment oxytocin cesarean Occasionally operative delivery during the second stage of labor, when the first or second stage of labor too slow preceded with relative mismatch or refractory uterine inertia and the fetus <5000 g (<4500 g in diabetic women) prevails, can the labor will be reinforced with oxytocin, which is the treatment of uterine inertia. If this causes a normal birth progress is reached again, the labor can continue. If not, there is either a relative disparity or intractable uterine inertia, so that a delivery by caesarean section is needed. In the second stage of labor, a forceps or vacuum extraction can be the appropriate therapy if previously both the size of the fetus, its location and height in the birth canal (2 cm below the maternal spinae ischiadicae [+2] or lower) was determined and assessment of the mother's pelvis is done. Uterine inertia is difficult to treat, but repositioning, short-acting Tocolytics (z. B. terbutaline 0.25 mg 1 time iv) discontinuation of oxytocin, if it is taken, and analgesics can help.

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