Dystocia is a difficult or abnormal delivery caused by various factors such as breech presentation, cephalopelvic disproportion, fetal tumors, or uterine problems. Diagnosis is made by an obstetrician or pediatrician through symptoms and imaging tests. Complications can include breathing depression, lack of oxygen, and fetal death. C-sections are often performed to manage dystocia.
Dystocia refers to abnormal or difficult delivery or labor. It can occur due to a breech presentation, due to cephalopelvic disproportion, due to the presence of fetal cancer or due to uterine problems that the mother may have. The diagnosis is often made by an obstetrician, a doctor who follows a woman from the moment of pregnancy until delivery. Most pediatricians diagnose dystocia through the symptoms presented by the mother during labor, by performing an internal examination in which she can palpate the body parts presenting the baby or with the help of an ultrasound, which is a test of imaging.
The normal position of the baby during a vaginal birth is head-first, also known as cephalic presentation. When other body parts, such as the back of the neck, feet, shoulders, or buttocks, appear in the birth canal first, delivery often becomes difficult. In cases where the shoulder is the presenting part, some obstetricians may perform certain maneuvers to try to deliver the baby vaginally. Risk factors for developing 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 large for the mother’s birth canal. Causes of cephalopelvic disproportion include maternal diabetes, postterm labor where the pregnancy is already more than 42 weeks old, and abnormal pelvic shape due to accidents or maternal acquired disease.
The presence of tumors in the fetus can also lead to dystocia. An example of a fetal tumor is sacrococcygeal teratoma, a common tumor found in the tailbone or coccyx bone of a newborn. Hydrocephalus is another condition that can result in dystocia. It is the accumulation of fluid inside the head of the fetus, thus causing the head to swell.
Uterine problems present in the mother can also lead to a difficult birth. Examples of these problems include defects in the muscles of the uterus and the presence of birth defects in the uterus. Congenital deformities of the coccyx and diseases that cause an abnormal shape of the pelvis can also contribute to difficult labor.
Complications that can result from dystocia include depression in breathing, intrauterine hypoxia where there is lack of oxygen going to the fetus, and fetal death. Obstetricians often manage dystocia by performing a C-section. A cesarean section is a surgical operation performed to deliver the baby by making an opening in the abdomen. Other reasons for having a C-section include infections in the mother’s genital tract, multiple babies in the womb, and fetal distress.
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