Dystocia (antonym eutocia) is an abnormal or difficult childbirth or labour. Approximately one fifth of human labours have dystocia. Dystocia may arise due to incoordinate uterine activity, abnormal fetal lie or presentation, absolute or relative cephalopelvic disproportion, or (rarely) a massive fetal tumor such as a sacrococcygeal teratoma. Oxytocin is commonly used to treat incoordinate uterine activity, but pregnancies complicated by dystocia often end with assisted deliveries, including forceps, ventouse or, commonly, caesarean section. Recognized complications of dystocia include fetal death, respiratory depression, Hypoxic Ischaemic Encephalopathy (HIE), and brachial nerve damage. A prolonged interval between pregnancies, primigravid birth, and multiple birth have also been associated with increased risk for labor
dystocia.
Shoulder dystocia is a dystocia in which the anterior shoulder of the infant cannot pass below the pubic symphysis or requires significant manipulation to pass below it. It can also be described as delivery requiring additional manoeuvres after gentle downward traction on the head has failed to deliver the shoulders.
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Nursing Intervention for Dystocia
- Assess and monitor fetal heart rate and fetal distress
- Monitor maternal temperature and heart rate
- Monitor uterine contraction
- Assist with pelvic examination, measurement, ultrasound or other procedures
- Administer antibiotic and IV fluid as prescribed
- Monitor intake and output
- Assess for dehydration
- Monitor color of amniotic fluid
- Teach mother in breathing and relaxing techniques
- Provide good rest and comforts
- Assess for prolapse of the cord