Abnormal uterine action
| A | Constriction ring | |
| B |
Schroeder’s ring |
|
| C |
Retraction ring |
|
| D |
Cervical dystocia |
Bandl’s ring is also called as :
| A |
Constriction ring |
|
| B |
Schroeder’s ring |
|
| C |
Retraction ring |
|
| D |
Cervical dystocia |
Ans. is c i.e. Retraction ring
Bandl’s ring is also called as Pathological retraction ring.
- It is formed in cases of obstructed labour°.
Physiology : In case of obstructed labour. the upper segment of the uterus contracts and retracts vigorously, in an attempt to overcome the obstruction while the lower segment dilates.
With each contraction there is myometrial shortening, so that the actively contracting upper segment becomes progressively thicker and shorter. The passive lower segment is progressively stretched and becomes thinner.
The junction between the two segments stands out prominently as a pathological retraction ring or Bandl’s ring. Situation : It runs obliquely and is always situated at the junction of upper and lower segment.
On abdominal examination : • Uterus is tense and tender
- Fetal parts are not easily felt
- Ring is felt as a groove placed obliquely
- FHS is absent
- Round ligaments are palpable.
On vaginal examination Ring cannot be felt vaginally.
Extra Edge
Constriction ring / Schroeder’s ring : Constriction ring is a form of incoordinate uterine action where there is localised spastic contraction of a ring of circular muscle fibres of the uterus.
| A | Level of external os | |
| B |
Level of internal os |
|
| C |
Level of isthmus |
|
| D |
Level of cervical canal |
Level of external os
Hypertonic dysfunctional labour is characterised by which of the following :
| A |
Fetal distress occurs early |
|
| B |
Reaction to oxytocin is favorable |
|
| C |
Sedation is of little value |
|
| D |
Occurs more frequently than hypotonic labour |
Fetal distress occurs early
Bandl’s ring is associated with :
| A |
Cephalopelvic disproportion |
|
| B |
Fetal death |
|
| C |
Uterine inertia |
|
| D |
Placenta previa |
Ans. is A. i.e. Cephalopelvic disproportion
- Bandl’s ring (also known as pathological retraction ring) is the abnormal junction between the two segments of the human uterus, which is a late sign associated with obstructed labor.
- Before the onset of labor, the junction between the lower and upper uterine segments is a slightly thickened ring.
- In abnormal and obstructed labors, after the cervix has reached full dilatation further contractions cause the upper uterine segment muscle fibers myometrium to shorten so that the actively contracting upper segment becomes thicker and shorter.
- The ridge of the pathological ring of Bandl’s can be felt or seen rising as far up as the umbilicus.
- The lower segment becomes stretched and thinner and if neglected may lead to uterine rupture.
- It is Major pathology behind obstructed labor. A circular groove encircling the uterus is formed between the active upper segment and the distended lower segment.
- Due to pronounced retraction, there is fetal jeopardy or even death.
All are true about constriction ring except :
| A |
Also called Schroeder’s ring |
|
| B |
Can be caused by injudicious oxytocin use |
|
| C |
Ring can be palpated per abdomen |
|
| D |
Inhalation of amyl nitrate relaxes the ring |
Ring can be palpated per abdomen
Bandl’s ring is seen in which of the following conditions ?
| A |
Undilated Cervix |
|
| B |
Premature rupture of membranes |
|
| C |
Obstructed labourInjudicious use of oxytocics |
|
| D |
All |
Obstructed labourInjudicious use of oxytocics
Constriction ring in uterus is seen in :
| A |
Obstructed labour |
|
| B |
Normal labour |
|
| C |
Both |
|
| D |
None |
None
