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La dystocie cervicale et la stagnation de la dilatation

La dystocie cervicale et la stagnation de la dilatation

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Arbre décisionnel :<br />

ARRET DE LA DILATATION DE 1 HEURE<br />

(absence <strong>de</strong> modification <strong>cervicale</strong> entre 2 TV)<br />

RECHERCHER UNE CAUSE ?<br />

DYNAMIQUE PATIENTE<br />

UTERINE ALGIQUE ?<br />

CORRECTE ?<br />

OUI<br />

BONNE APPLICATION NON<br />

DE LA PRESENTATION ?<br />

OUI<br />

NON Ocytociques<br />

• Proposer une<br />

• Ocytociques.<br />

APD ou<br />

• RAM.<br />

réinjecter.<br />

• Gluconate <strong>de</strong> calcium®.<br />

• Rechercher <strong>de</strong>s<br />

positions<br />

OUI<br />

antalgiques.<br />

• Protoxy<strong>de</strong><br />

d’azote.<br />

NON<br />

• RAM.<br />

• Changement <strong>de</strong> position.<br />

• Vidange vésicale.<br />

80

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