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Dystocia refers to abnormal or difficult childbirth or labor. It may occur due to breech birth presentation, due to cephalopelvic disproportion, due to the presence of fetal tumor, or due to uterine problems the mother may have. Diagnosis is often made by an obstetrician, a doctor who manages a woman from the time she becomes pregnant until she gives birth. Most pediatricians diagnose dystocia through the symptoms presented by the mother during labor, by doing an internal examination where she can palpate the child's presenting body parts, or with the aid of an ultrasound, which is an imaging test.
The normal position of the baby during a vaginal delivery is head-first, also known as cephalic presentation. When other parts of the body, such as the back of the neck, feet, shoulder, or the buttocks, appear first on the birth canal, delivery often becomes difficult. In cases where the shoulder is the presenting part, some obstetricians may do certain maneuvers to try delivering the child vaginally. Risk factors for the occurrence of shoulder dystocia include maternal obesity, uncontrolled diabetes, and prolonged labor.
Cephalopelvic disproportion is one of the most common causes of dystocia. This usually occurs when the fetus is too big in relation to the birth canal of the mother. Causes of cephalopelvic disproportion include maternal diabetes, post-term labor where the pregnancy is already more than 42 weeks old, and abnormal pelvic shape due to accidents or diseases acquired by the mother.
The presence of tumors in the fetus can also lead to dystocia. Example of a fetal tumor is sacrococcygeal teratoma, which is a common tumor found in a newborn's tailbone or coccyx bone. Hydrocephalus is another condition that can result in dystocia. It is the accumulation of fluid inside the head of the fetus, thus making the head swell.
Uterine problems present in the mother can also result in a difficult childbirth. Examples of these problems include defects in the muscles of the uterus and presence of congenital defects in the uterus. Congenital deformities in the tailbone as well as diseases that result in abnormal pelvis shape may also contribute to the occurrence of a difficult labor.
Complications that may arise from dystocia includes depression in breathing, intrauterine hypoxia where there is lack of oxygen going to the fetus, and death of the fetus. Obstetricians often manage dystocia by performing a cesarean section. A cesarean section is a surgical operation done to deliver the baby by making an opening in the abdomen. Other reasons for doing a cesarean section include infections in the genital tract of the mother, multiple babies in the womb, and fetal distress.