Cervical dystocia occurs when the cervix fails to dilate during labor despite contractions. There are two types: primary occurs in first births and is caused by excessive fibrous tissue or spasmic muscles; secondary results from scarring or rigidity from previous operations or diseases. Results include the cervix becoming thinned but applied to the head, contractions become ineffective, and the anterior lip may edematize. Management depends on safety of vaginal delivery and how low the head is - it may include manually pushing the head up during contractions, traction, or Duhrssen's incisions followed by ventouse or forceps.

1. CERVICAL DYSTOCIA
MIDWIFERY
12/06/2020

2. DEFINITION
• CERVICAL DYSTOCIA IS ONE WHERE THE DESPITE
EFFECTIVE CONTRACTIONS OF THE CERVIX
(external os ) FAILS TO DILATE , ALTHOUGH IT MAY
EFFACE .

3. TYPES OF CERVICAL DYSTOCIA
1. PRIMARY
PRIMARY TYPE OF DYSTOCIA OCCURS PREDOMINANTLY DURING THE
FIRST BIRTH .THE NON DILATION MAY BE DUE TO THE PRESENCE OF
EXCESSIVE FIBROUS TISSUE OR SPASM OF CIRCULAR MUSCLE FIBRES
SURROUNDING THE OS .

4. CONTINUED…..
2.SECONDARY
THE SECONDARY CERVICAL DYSTOCIA RESULTS USUALLY FROM THE EFFECT OF
SCARRING OR RIGIDITY OF CERVIX FROM THE EFFECT OF PREVIOUS OPERETION
OR DISEASES

5. RESULT OF CERVICAL DYSTOCIA
ETIOLOGY
THE CERVIX BECOMES TINNED AND OUT AND WELL APPLIED TO THE HEAD
INITIALLY, THE UTERUS CONTRACTIONS REMAIN GOOD,
BUT LATER BECOME INEFFECTIVE
EDEMA OF THE ANTERIOR LIP OCCUR
DELIVERY MAY BE ACCOMPLISHED BY AVULSION
(TEARING AWAY ) OF THE ANTERIOR LIP OR
DETACHMENT OF THE CERVIX

6. MANAGEMENT
IN THE PRESENCE OF ASSOCIATED COMPLICATIONS , WHERE
VAGINAL DELIVERY IS FOUND UNSAFE , CESAREAN SECTION IS
PERFORMED
IF THE HEAD IS SUFFICIENTLY LOW DOWN WITH ONLY THICK CERVIX
LEFT
IT IS THEN PUSHED UP MANNUALY DURING CONTRACTION OR
TRACTION GIVEN BY VENTOUSE
IN OTHER WHERE THE CERVIX IS VERY THINNED OUT , BUT ONLY
HALF DILATED A DUHRSSEN ‘S INCISION AT 2 AND 10 O’CLOCK
POSITIONS MAY BE FOLLOWED BY VENTOUSE OR FORCEPS