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Topics in Companion Animal Medicine Mar 2018Dystocia can be defined broadly as "difficult birth" or more specifically as difficulty in the bitch expelling the pups through the cervix, vagina, and vestibule. It is... (Review)
Review
Dystocia can be defined broadly as "difficult birth" or more specifically as difficulty in the bitch expelling the pups through the cervix, vagina, and vestibule. It is a fairly common emergency presented to the small animal practitioner with an incidence rate of approximately 5%. The incidence of dystocia is highest in toy and brachycephalic breeds, and occurs frequently in small litters (<3 pups) due to fetal oversize and delayed onset of labor. As duration of labor progresses, the mortality of the pups and even the bitch increases, with the highest number of stillborn pups occurring after 6 hours from the time of active parturition. Practitioners should understand the mechanism of normal parturition so that abnormalities can be readily identified and medical or surgical intervention performed in a safe and timely manner.
Topics: Animals; Cesarean Section; Dog Diseases; Dogs; Dystocia; Female; Pregnancy
PubMed: 29793723
DOI: 10.1053/j.tcam.2018.03.003 -
Obstetrics and Gynecology Clinics of... Jun 1999Shoulder dystocia is an infrequent and unexpected emergency requiring rapid and deft solution. Identifiable risk factors include maternal diabetes, fetal macrosomia... (Review)
Review
Shoulder dystocia is an infrequent and unexpected emergency requiring rapid and deft solution. Identifiable risk factors include maternal diabetes, fetal macrosomia (especially in the presence of diabetes), and maternal history of previous delivery of a large infant. Other reported risk factors include arrest and protraction disorders of labor and midpelvic operative delivery; however, more than 50% of shoulder dystocia occurs in instances without identifiable risk factors, and permanent neonatal injury is thus unpredictable. Therefore, all personnel in the delivery suite must be well versed in the timely and appropriate application of corrective measures. Although most instances of shoulder dystocia cannot be predicted, the judicious use of CS delivery in diabetic patients with expected birth weights of more than 4250 g should reduce the risk of shoulder dystocia in this subgroup of patients. A trial of labor for nondiabetic patients with suspected fetal macrosomia is recommended because predicting actual birth weights in this population remains difficult.
Topics: Cesarean Section; Dystocia; Female; Humans; Infant, Newborn; Labor Stage, Second; Labor, Induced; Malpractice; Obstetric Labor Complications; Pregnancy; Prenatal Injuries; Risk Factors; Shoulder
PubMed: 10399767
DOI: 10.1016/s0889-8545(05)70080-2 -
Seminars in Perinatology Jun 2014Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to... (Review)
Review
Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery.
Topics: Adult; Cesarean Section; Delivery, Obstetric; Dystocia; Extraction, Obstetrical; Female; Fetal Macrosomia; Humans; Incidence; Infant, Newborn; Male; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; Risk Factors; Shoulder Injuries
PubMed: 24863023
DOI: 10.1053/j.semperi.2014.04.003 -
Clinical Obstetrics and Gynecology Dec 2016Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its... (Review)
Review
Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its occurrence remains largely unpredictable and unpreventable.
Topics: Birth Injuries; Birth Weight; Delivery, Obstetric; Dystocia; Female; Humans; Incidence; Infant, Newborn; Pregnancy; Recurrence; Risk Factors; Shoulder
PubMed: 27662540
DOI: 10.1097/GRF.0000000000000227 -
Seminars in Perinatology Jun 2014Shoulder dystocia is an obstetric emergency that has been reported to occur in 0.2-3% of all vaginal deliveries. Several characteristics of shoulder dystocia make it a... (Review)
Review
Shoulder dystocia is an obstetric emergency that has been reported to occur in 0.2-3% of all vaginal deliveries. Several characteristics of shoulder dystocia make it a particular challenge to manage effectively. It is relatively infrequent, the diagnosis cannot be made according to a single objective criterion that can be recognized to exist by all members of the care team who are present, it is unpredictable, and there is the need for coordinated actions of all members of the health care team who have come together on the day of the delivery and may not have worked together before or specifically during a shoulder dystocia. In general, there is evidence from different medical disciplines that checklists/protocols and simulation may be used to enhance team performance. There is also some evidence, albeit limited, that such techniques may be used to improve shoulder dystocia outcomes.
Topics: Adult; Checklist; Clinical Protocols; Delivery, Obstetric; Dystocia; Evidence-Based Emergency Medicine; Female; Humans; Infant, Newborn; Male; Patient Care Team; Patient Simulation; Pregnancy; Shoulder Injuries
PubMed: 24863026
DOI: 10.1053/j.semperi.2014.04.006 -
American Family Physician Jun 2007Dystocia is common in nulliparous women and is responsible for more than 50 percent of primary cesarean deliveries. Because cesarean delivery rates continue to rise,... (Review)
Review
Dystocia is common in nulliparous women and is responsible for more than 50 percent of primary cesarean deliveries. Because cesarean delivery rates continue to rise, physicians providing maternity care should be skilled in the diagnosis, management, and prevention of dystocia. If labor is not progressing, inadequate uterine contractions, fetal malposition, or cephalopelvic disproportion may be the cause. Before resorting to operative delivery for arrested labor, physicians should ensure that the patient has had adequate uterine contractions for four hours, using oxytocin infusion for augmentation as needed. For nulliparous women, high-dose oxytocin-infusion protocols for labor augmentation decrease the time to delivery compared with low-dose protocols without causing adverse outcomes. The second stage of labor can be permitted to continue for longer than traditional time limits if fetal monitoring is reassuring and there is progress in descent. Prevention of dystocia includes encouraging the use of trained labor support companions, deferring hospital admission until the active phase of labor when possible, avoiding elective labor induction before 41 weeks' gestation, and using epidural analgesia judiciously.
Topics: Analgesia, Epidural; Analgesia, Obstetrical; Dystocia; Female; Humans; Labor Stage, First; Labor Stage, Second; Labor, Induced; Parity; Pregnancy
PubMed: 17575657
DOI: No ID Found -
Revista Brasileira de Ginecologia E... Jul 2022
Topics: Delivery, Obstetric; Dystocia; Female; Humans; Pregnancy; Shoulder Dystocia
PubMed: 35940174
DOI: 10.1055/s-0042-1755446 -
The Veterinary Clinics of North... Jul 2016Dystocia is an inevitable challenge in the livestock industries, particularly with primiparous female animals. Prevention and appropriate management will decrease cow... (Review)
Review
Dystocia is an inevitable challenge in the livestock industries, particularly with primiparous female animals. Prevention and appropriate management will decrease cow and calf morbidity and mortality, which will improve the economic status of the beef or dairy operation. Early identification and proper intervention improves outcomes, and the use of selection tools to decrease the potential for dystocia will have positive returns. Assisted reproductive technologies present a unique set of challenges to the calving process that both the producer and practitioner should be prepared to address.
Topics: Animal Husbandry; Animals; Cattle; Cattle Diseases; Dairying; Dystocia; Female; Pregnancy; Selective Breeding
PubMed: 27324453
DOI: 10.1016/j.cvfa.2016.01.016 -
Tierarztliche Praxis. Ausgabe G,... Feb 2023In horses, birth is classified as dystocia when the process of parturition threatens to inflict damage onto the mare or the foal, when assistance is required to complete... (Review)
Review
In horses, birth is classified as dystocia when the process of parturition threatens to inflict damage onto the mare or the foal, when assistance is required to complete the process of parturition, or when there are temporal deviations in the physiological duration of the first and/or second parturition stages. In this, the duration of the second stage is an important indicator in identifying dystocia, as this phase is easily discernible by the mare's behavior. Equine dystocia is classified as an emergency with life-threatening consequences for mare and foal. A large degree of variation has been found in the reported incidence of dystocia. Stud farm surveys reported dystocia in 2-13% of all births, regardless of breed. Fetal malpositioning of the limbs and neck during parturition is described as the most common cause of dystocia in horses. The species-specific length of limbs and neck is considered to be the reason for this finding.
Topics: Pregnancy; Animals; Horses; Female; Incidence; Parturition; Dystocia; Horse Diseases
PubMed: 36913938
DOI: 10.1055/a-2006-9248 -
The Veterinary Clinics of North... Sep 2023Canine Cesarean Section (CS) is primarily performed to increase survival of newborns and less commonly to save the life or reproductive future of the dam. Conducting... (Review)
Review
Canine Cesarean Section (CS) is primarily performed to increase survival of newborns and less commonly to save the life or reproductive future of the dam. Conducting proper ovulation timing to accurately predict the due date will allow a planned, elective CS as an excellent alternative to a high-risk natural whelping, and possible dystocia, for certain breeds and situations. Techniques for ovulation timing, anesthesia, and surgery tips are provided.
Topics: Pregnancy; Animals; Dogs; Female; Cesarean Section; Reproduction; Dystocia; Dog Diseases
PubMed: 37246012
DOI: 10.1016/j.cvsm.2023.04.007