引言位置：https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Translation_task_force/RTT/Simple_obstructed_labour
中文條目：https://zh.wikipedia.org/zh-tw/難產
’’’ 難產’’’指[[分娩]]時困難或出現不正常的問題。據統計，人類分娩中大約有1/5有難產問題。難產的原因可能是[[子宮]]活動不協調，胎兒位置或方向不正常，或胎兒體積不正常。[[催生素]]常被用來幫助子宮活動。出現難產的懷孕，多數會以[[產鉗]]、[[吸杯]]方法助產。現時更多難產個案會以 [[剖腹生產]]。難產可導致的問題包括胎兒死亡、呼吸困難、腦細胞受損等問題。
肩難產（Shoulder Dystocia）是指胎兒頭部分娩後，前肩在恥骨聯合之下不能通過。
<!-- Definition and symptoms -->
Obstructed labour, also known as labour dystocia, is when, even though the uterus is contracting normally, the baby does not exit the pelvis during childbirth due to being physically blocked.[1] Complications for the baby include not getting enough oxygen which may result in death. It increases the risk of the mother getting an infection, having uterine rupture, or having post-partum bleeding.[2] Long term complications for the mother include obstetrical fistula. Obstructed labour is said to result in prolonged labour, when the active phase of labour is longer than twelve hours.[1]
’’’難產’’’（Obstructed labour）是指[[分娩]]時，[[子宮]]雖然正常收縮，但卻因物理因素無法順利產出胎兒的情形[1]。難產誘發的併發症除了因胎兒缺氧造成致命性的{{le|周產期窒息|Perinatal asphyxia}}，母體也可能遭受感染、[[子宮破裂]]，或出現{{le|產後出血|post-partum bleeding}}的情形[2]。母體的長期的併發症包括[[生產性瘻管]]。一般相信難產的主因是{{le|滯產|prolonged labour}}，即生產過程超過一般約12小時的分娩時程[1]。
<!-- Causes and diagnosis -->
The main causes of obstructed labour include: a large or abnormally positioned baby, a small pelvis, and problems with the birth canal. Abnormal positioning includes shoulder dystocia were the anterior shoulder does not pass easily below the pubic bone.[1] Risk factors for a small pelvis include malnutrition and a lack of exposure to sunlight causing vitamin D deficiency.[3] It is also more common in adolescence as the pelvis may not have finished growing.[2] Problems with the birth canal include a narrow vagina and perineum which may be due to female genital mutilation or tumors.[1] A partograph is often used to track labour progression and diagnose problems.[2] This combined with physical examination may identify obstructed labour.[4]
＜成因及診斷＞
造成難產的主要因素包括：胎兒體型較大或胎位不正、骨盆腔狹小以及產道異常。胎位不正，包括[[肩難產]]，是前肩無法順利從恥骨下通過[1]。造成骨盆腔狹小的危險因子包括[[營養不良]]以及缺乏日照所造成的[[維生素D缺乏]][3]。青少年產婦由於骨盆腔尚未發育完全，也較常見有骨盆腔狹小的問題[2]。產道問題則包含了狹窄的陰道和會陰部，可能的成因是[[女性生殖器切割]]或是[[腫瘤]][1]。[[產程圖]]常用來追蹤產程進展並診斷產程問題[2]。產程圖配合理學檢查可診斷出難產。
<!-- Management and epidemiology-->
The treatment of obstructed labour may require cesarean section or vacuum extraction with possible surgical opening of the symphysis pubis. Other measures include: keeping the women hydrated and antibiotics if the membranes have been ruptured for more than 18 hours.[5] In Africa and Asia obstructed labor effects between two and five percent of deliveries.[6] In 2013 it resulted in 19,000 deaths down from 29,000 deaths in 1990 (about 8% of all deaths related to pregancy).[7][1] Most deaths due to this condition occur in the developing world.[2]
<處置與流行病學>
處理難產的狀況可能需要[[剖腹生產]]或是[[真空吸引]]，甚至可能進行[[恥骨聯合切開術]]。其他的處置包括持續給予孕婦充分的水份，如果[[羊膜]]已經破裂長達18個小時以上需投與[[抗生素]] [5]。在非洲與亞洲，難產的發生率為總生產量的百分之二到五[6]。在2013年，難產造成了19000個死亡案例，和1990年的29000例較為下降(難產大約與百分之八的[[死因相關]]) [1][7]。與難產相關的死亡案例大多發生於[[開發中國家]] [2]。