#obgyn
Etiology of Dystocia: The 4 P’s
1 . Power
• Contractions may be hypotonic or inco-ordinate
• Maternal expulsive efforts may be inadequate
2 . Passenger
• Fetal position
• Fetal attitude
• Fetal size
• Fetal anomalies (hydrocephalus)
3 . Passage
• Pelvic structure
• Soft tissue obstruction (tumors, full bladder/full rectum, vaginal septum)
4 . Psyche
• Anxiety
• Stress
• Pain
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Details