Dystocia

Classification according to ICD-10
O62.4	Hypertonic, uncoordinated, and persistent uterine contractions - uterine dystocia onA
O66	Other obstacles to childbirth
ICD-10 online (WHO version 2019)

A dystocia ( ancient Greek δυστοκἰα dystokia “difficult birth”, from δυς dys “bad” and τὁκος tokos “birth”) is a disturbed birth process in the sense of a difficult delivery . Willibald Pschyrembel defined dystocia as a labor anomaly with continuous contractions (tetanus uteri), with excessive contractions (hypersystole), with too frequent contractions (polysystole) or with an increased basic tone. This narrow definition in the sense of too strong labor is now being taken more broadly in his dictionary : Today, dystocia describes any disturbed course of labor due to mechanical, organic or functional causes. There are four forms of pelvic dystocia , shoulder dystocia, labor dystocia and cervical dystocia . About six percent of all deliveries are such high-risk births . One speaks of the difficult birth . The opposite of dystocia is normal birth ( eutocia ). In French , the terms dystocie maternelle and dystocie foetale are used to distinguish between maternal and child causes.

causes

In most cases, dystocia is non-progressive labor ( uterine weakness ). With a shoulder dystocia one's shoulder of the child in the birth canal pinched. Other causes are child or maternal anomalies such as the child's lateral position , a hydrocephalus , a too narrow maternal pelvis , a soft tissue rigidity , a placenta accreta , a placenta adhesives , a placenta previa , a cervical stricture ( cervical dystocia), a uterine spasm or Siamese twins .

diagnosis

The focus is on a thorough physical examination. Sonography and cardiotocography and, with restrictions, amniocentesis and partogram are also helpful . X-ray diagnostics , computed tomography and magnetic resonance tomography only in exceptional cases.

therapy

In addition to the extensive possibilities of conservative obstetrics has a episiotomy and the caesarean section ( cesarean are) intended. There are blow-promoting (for example dinoprostone ) and tocolytic (eg fenoterol , atosiban ) drugs .

Individual evidence

^ Willibald Pschyrembel : Clinical Dictionary , 48th - 53rd edition, Walter de Gruyter , Berlin 1942, page 162.
^ Willibald Pschyrembel : Practical Obstetrics and Obstetric Operations , 14th edition, de Gruyter , Berlin and New York 1973, ISBN 3-11-001683-4 , page 774.
^ Pschyrembel (Medical Dictionary) , 266th edition, de Gruyter , Berlin and Boston 2014, ISBN 978-3-11-033997-0 , page 536.
^ Otto Dornblüth : Dictionary of clinical art expressions , Verlag von Veit & Comp., Leipzig 1894, page 35.
↑ Maxim Zetkin and Herbert Schaldach: Dictionary of Medicine , 15th edition, Ullstein Mosby Verlag, Berlin 1992, ISBN 3-86126-018-2 and ISBN 3-86126-015-8 , page 536.
^ Otto Dornblüth : Clinical Dictionary , 3rd edition, Verlag von Veit & Comp., Leipzig 1907, page 62.
^ Günter Thiele ( editor ): Handlexikon der Medizin , Urban & Schwarzenberg , Munich, Vienna, Baltimore 1980, Volume 1, Page 586.

[1] Willibald Pschyrembel : Clinical Dictionary , 48th - 53rd edition, Walter de Gruyter , Berlin 1942, page 162.

[2] Willibald Pschyrembel : Practical Obstetrics and Obstetric Operations , 14th edition, de Gruyter , Berlin and New York 1973, ISBN 3-11-001683-4 , page 774.

[3] Pschyrembel (Medical Dictionary) , 266th edition, de Gruyter , Berlin and Boston 2014, ISBN 978-3-11-033997-0 , page 536.

[4] Otto Dornblüth : Dictionary of clinical art expressions , Verlag von Veit & Comp., Leipzig 1894, page 35.

[5] Maxim Zetkin and Herbert Schaldach: Dictionary of Medicine , 15th edition, Ullstein Mosby Verlag, Berlin 1992, ISBN 3-86126-018-2 and ISBN 3-86126-015-8 , page 536.

[6] Otto Dornblüth : Clinical Dictionary , 3rd edition, Verlag von Veit & Comp., Leipzig 1907, page 62.

[7] Günter Thiele ( editor ): Handlexikon der Medizin , Urban & Schwarzenberg , Munich, Vienna, Baltimore 1980, Volume 1, Page 586.