Additionally, cesarean surgery increases risks for surgical complications, postoperative infection, and future pregnancy complications such as uterine rupture, abnormal placentation, ectopic pregnancy, and stillbirth. Benefits of vaginal birth include reduced postpartum pain, improved maternal/neonatal bonding, increased breastfeeding rates, and reduced rates of childhood asthma, type I diabetes, allergies, and obesity. However, cesarean surgery is a major abdominal operation with significant risks, while vaginal birth affords important physiologic signals that contribute to maternal and neonatal health and wellbeing. We conclude that additional knowledge of parturition physiology coupled with rigorous clinical evaluation of novel biologically directed treatments could improve obstetric quality of care.īackground: Current Diagnosis and Management of Labor DystociaĬesarean surgery is a life-saving procedure that can dramatically improve obstetric safety. More precise diagnostic tools and individualized therapies for labor dystocia might lead to better outcomes. We found that the pathophysiologic basis of labor dystocia is under-researched, offering wide opportunities for translational investigation of individualized labor management, particularly regarding uterine metabolism and fetal position. However, treatments targeting specific underlying etiologies could be more effective. The variation in pathophysiologic causes of labor dystocia probably limits the utility of current general treatment options. We also describe current clinical approaches to preventing and managing labor dystocia. We review recent data on uterine preparation for labor, uterine contractility, cervical preparation for labor, maternal obesity, cephalopelvic disproportion, fetal malposition, intrauterine infection, and maternal stress. We summarize known mechanisms supported by clinical and experimental data and newer hypotheses with less supporting evidence. We conducted a literature review of the causes and pathophysiologic mechanisms of labor dystocia. A better understanding of the pathophysiologic mechanisms of labor dystocia could lead to new clinical opportunities to increase the rate of normal vaginal delivery, reduce cesarean birth rates, and improve maternal and neonatal health. Labor dystocia is a complex disorder due to multiple causes with a common clinical outcome of slow cervical dilation and fetal descent. Reducing the rate of unplanned cesarean birth in the USA has been a public health priority over the last two decades with limited success. It is the indication for about half of unplanned cesarean deliveries in low-risk nulliparous women. It provides support to the uterus.Abnormally prolonged labor, or labor dystocia, is a common complication of parturition.
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