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Deep Transverse Arrest Detail Answer From DC Dutta...

Deep transverse arrest is a labor complication where the fetal head fails to rotate from a transverse position, leading to obstructed labor. Causes include cephalopelvic disproportion, malposition, weak contractions, and maternal or fetal abnormalities. Management options range from expectant management and manual rotation to instrumental delivery or cesarean section if necessary.

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65 views2 pages

Deep Transverse Arrest Detail Answer From DC Dutta...

Deep transverse arrest is a labor complication where the fetal head fails to rotate from a transverse position, leading to obstructed labor. Causes include cephalopelvic disproportion, malposition, weak contractions, and maternal or fetal abnormalities. Management options range from expectant management and manual rotation to instrumental delivery or cesarean section if necessary.

Uploaded by

Vipul Rajora
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Unfortunately, I don't have access to the specific content of textbooks like "DC Dutta Textbook of

Obstetrics." Copyright restrictions and the inability to access physical books limit my knowledge
to generally available information.
However, I can provide you with a detailed explanation of deep transverse arrest, drawing from
general medical knowledge.
Deep Transverse Arrest
Deep transverse arrest is a complication of labor that occurs when the fetal head descends into
the pelvis but fails to rotate from a transverse position to an anterior-posterior position. This
prevents further descent and can lead to obstructed labor.
Causes:
●​ Cephalopelvic Disproportion (CPD): The fetal head is too large or the maternal pelvis is
too small for the head to pass through.
●​ Malposition: The fetal head may be in an occipito-transverse or occipito-posterior
position.
●​ Weak Uterine Contractions: Ineffective contractions may fail to provide sufficient force
for rotation and descent.
●​ Maternal Pelvic Abnormalities: Variations in pelvic shape or structure can hinder
rotation.
●​ Fetal Abnormalities: Macrosomia (large fetal size) or hydrocephalus (fluid accumulation
in the brain) can contribute.
Diagnosis:
●​ Vaginal Examination: The fetal head is felt in a transverse position at or below the level
of the ischial spines.
●​ Imaging: Ultrasound or X-ray may be used to confirm the diagnosis and assess the
position and size of the fetal head and maternal pelvis.
Management:
●​ Expectant Management: If the mother and fetus are stable, and there are signs of
progress, a short trial of labor may be allowed to see if spontaneous rotation occurs.
●​ Manual Rotation: The obstetrician may attempt to manually rotate the fetal head using
their hand during a vaginal examination.
●​ Instrumental Delivery: If manual rotation fails, forceps or vacuum extraction may be
used to assist with delivery.
●​ Cesarean Section: If other methods are unsuccessful or unsafe, a cesarean section is
performed to deliver the baby.
Complications:
●​ Prolonged Labor: Deep transverse arrest can significantly prolong labor.
●​ Fetal Distress: Compression of the umbilical cord can lead to fetal distress.
●​ Maternal Morbidity: Increased risk of infection, postpartum hemorrhage, and perineal
trauma.
●​ Uterine Rupture: In rare cases, prolonged obstructed labor can lead to uterine rupture.
Prevention:
●​ Antenatal Care: Regular prenatal checkups to assess fetal growth and maternal pelvic
adequacy.
●​ Encouraging Labor Positions: Positions like squatting or kneeling can help facilitate
rotation.
●​ Adequate Pain Relief: Effective pain management can help promote relaxation and
efficient contractions.
Key Points from DC Dutta (likely content based on general obstetrics knowledge):
●​ Emphasis on Pelvic Assessment: The textbook likely highlights the importance of
careful pelvic assessment during antenatal care to identify potential problems.
●​ Detailed Description of Manual Rotation Techniques: It probably provides step-by-step
instructions on how to perform manual rotation safely.
●​ Discussion of Instrumental Delivery: The book likely discusses the indications,
contraindications, and techniques for forceps and vacuum delivery in deep transverse
arrest.
●​ Clear Guidelines for Cesarean Section: It likely outlines the situations where cesarean
section is the preferred mode of delivery.
●​ Maternal and Fetal Monitoring: The importance of close monitoring of both the mother
and fetus during labor is likely emphasized.
Remember: This information is for general knowledge only. Always consult a qualified
healthcare professional for diagnosis and treatment. If you have access to the DC Dutta
Textbook of Obstetrics, refer to it for the most accurate and detailed information on deep
transverse arrest.

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