|Classification and external resources|
Obstructed labour, dystocia (antonym eutocia; Ancient Greek: τόκος tókos “childbirth”) 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.
A prolonged second stage of labour is another type of dystocia whereby the fetus has not been delivered within three hours in a nulliparous woman, or two hours in multiparous woman, after her cervix has become fully dilated.
Synonyms for dystocia include difficult labour, abnormal labour, difficult childbirth, abnormal childbirth, and dysfunctional labour.
As of 2010 obstructed labour resulted in about 11,000 deaths down from 19,000 in 1990.
The term can also be used in the context of various animals. Dystocia pertaining to birds and reptiles is also called egg binding.
- Zhu, B.P.; Grigorescu, V.; Le, T.; Lin, M. et al. (July 2006). "Labor dystocia and its association with interpregnancy interval". American Journal of Obstetrics and Gynecology 195 (1): 121–8. doi:10.1016/j.ajog.2005.12.016. PMID 16635468.
- Lozano, 68786R.; et al. (Dec 15, 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010.". Lancet 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. PMID 23245604.