1. Abnormal labor and Dystocia Dept. of Ob&Gyn, The first affiliated hospital He Ke

6. Friedman’s curve

7. Latent phase Active phase I II stage 产程图 partogram

9. Protraction disorders 􀁺 Nulliparas Multiparas Descent <1.0 cm/h <2.0 cm/h Dilation <1.2 cm/h <1.5 cm/h Average 8hr 5hr

10. Arrest disorder 􀁺 Nulliparas Multiparas Descent >2h >1h Dilation >2h >1h

11. Partogram

12. A 潜伏期延长 prolonged latent phase B 活跃期延长 prolonged active phase C 活跃期停滞 arrest active phase Abnormal partogram

13. Partogram

14. Precipitate labor disorders 􀁺 Nulliparas Multiparas Descent >5cm/hr >10cm/hr Dilation >5cm/hr >10cm/hr

17. Fetal monitoring

18. External and internal monitor

23. Pathological retraction ring

24. Constriction ring

27. Hypertonic Dysfunction

32. Three level of bony pelvis

34. Three anteroposterior diameters of the pelvic inlet

35. D iameter of the inlet and midpelvis

36. Fetopelvic disproportion

37. 正常骨盆 入口呈心型 出口呈漏斗型 funnel shaped pelvis 47.3% 5.8% 36.6% 10.9% gynecoid android Flat(platypelloid) anthropoid 前后径 狭 窄 横径 狭窄 transversely contracted pelvis 女性 男性

38. each pelvic plane is 2 cm less than normal 均小骨盆 generally contracted pelvis

39. osteomalacia oblique pelvis kyphosis 成人 行走之前 行走之后 Deformed pelvis

41. Birth canal

42. Pelvic mass

43. Pelvic mass

44. Low –lying placenta

46. 13.3 9.5 11.3

48. ★ ★ Cepholic position and the diameter through pelvis occiput presentation parietal presentation brow presentation face presentation

49. Malpresentation

51. Breech presentation

52. Transverse fetal lie

53. Shoulder presentation

54. Examination

55. Fetal macrosomia large for gestational age(LGA) ≥4000g

56. Shoulder dystocia

58. Brachial Plexus Injury

59. Fetal malformation

61. Operative delivery Vacuum

62. Operative delivery Cesarean Section