What are the complications of abnormal dystocia of soft birth canal?

summary

Dystocia caused by abnormal soft birth canal is far less than dystocia caused by abnormal bone birth canal, so it is easy to be ignored, resulting in missed diagnosis. The soft birth canal includes the lower uterine segment, cervix, vagina and vulva. The lesions of the soft birth canal itself can cause dystocia. The lesions of other parts of the reproductive tract and its surrounding may also affect the soft birth canal, making delivery difficult. However, the former is more common, so vaginal examination should be performed routinely in early pregnancy to find out whether there are abnormalities in the genital tract and pelvic cavity.

What are the complications of abnormal dystocia of soft birth canal?

1. The degree, thickness and hardness of cervical dilatation (based on the comparison of the peak of uterine contraction), whether there is edema in the cervix and the location and degree of edema, and whether there is a gap between the cervix and the fetal head at the peak of uterine contraction are very helpful to judge the type, nature and degree of dystocia.

2. Find out the fetal position: the direction of sagittal suture and the position of anterior and posterior fontanelle are the most important. Special attention should be paid to the possibility that the anterior fontanel and posterior fontanel may be mistaken and the sagittal suture may not be clear when the fetal head is seriously edematous and the skull overlaps obviously. In the vaginal examination before the operation of midwifery in the second stage of labor, the direction of auricle is often used to help judge whether the fetal position is accurate.

3. Make clear the level of fetal presentation: This is very important for the diagnosis of dystocia (including the judgment of whether fetal presentation can pass through the bone birth canal) and the decision of treatment (vaginal delivery or cesarean section). Therefore, for those with severe fetal head edema, the lowest point of the skull should be taken as the standard of fetal exposure, and sometimes the other hand should be used to check whether the biparietal diameter of the fetal head has passed through the pelvic entrance plane, especially for those with severe fetal head deformation. Sometimes the lowest point of the fetal head has even been exposed, and the biparietal diameter is still stuck above the pelvic entrance.

matters needing attention

The influence of abnormal soft birth canal on parturient women (1) prolonged delivery time makes parturient women tired, which is unfavorable to parturient women with complications, such as pregnancy induced hypertension, heart and lung diseases, and increases the operation rate（ 2) Such as abnormal fetal position and / or rotation, labor stagnation, resulting in dystocia and birth injury（ 3) Premature rupture of membranes, prolonged labor, causing intrauterine infection（ 4) Forceps assisted delivery, craniotomy and other operations increased the chance of birth injury（ 5) The expansion of soft birth canal is blocked, leading to abnormal labor pain, which is not conducive to delivery.