Dawaa Reference

Clinical reference

Fetal-maternal disproportion

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Cesarean Delivery - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK546707/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class WD71.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • Labour proper means regular painful contractions that are effacing and dilating the cervix [uterine contractions]
  • Ask when the contractions began and how far apart they are coming [uterine contractions]

Signs — what you find (4)

  • Abdominal examination gives the estimated fetal weight and the presentation
  • Vaginal examination assesses the shape and capacity of the bony pelvis alongside the cervix
  • Repeated examinations track position, station and descent - that is how normal progress is told from abnormal
  • The fetal heart trace may reassure, but it does not diagnose acidaemia

Tests (6)

  • On external monitoring aim for 3 to 5 contractions in a ten-minute window, each lasting 30 to 40 seconds
  • Adequate activity is 200 to 250 Montevideo units
  • Montevideo units are the net contraction pressures added up across ten minutes
  • An intrauterine catheter measures true contraction strength, and is used once membranes have ruptured
  • An occiput posterior baby means a longer second stage and more caesareans
  • Turning the head manually shortens the second stage and beats repositioning the mother

If not this — what else fits (2)

  • Bandl ring, Braxton Hicks contractions, cervical stenosis or chorioamnionitis
  • Abruption, ruptured membranes, prodromal labour, a Mullerian anomaly, or a ruptured uterus

SourceStatPearls "Abnormal Labor in Obstetrics: Recognition and Management" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Cephalopelvic disproportion occurs when the fetal head is too large or the maternal pelvis too small to allow safe vaginal delivery. In primary care or antenatal clinic, suspect disproportion in primigravidae with unengaged fetal head at term, short maternal stature, or suspected fetal macrosomia. Refer promptly to an obstetric facility for pelvimetry, ultrasound fetal weight estimation, and planning of elective or emergency C-section to prevent obstructed labour. - Refer, with advice

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Cephalopelvic disproportion occurs when the fetal head is too large or the maternal pelvis too small to allow safe vaginal delivery. In primary care or antenatal clinic, suspect disproportion in primigravidae with unengaged fetal head at term, short maternal stature, or suspected fetal macrosomia. Refer promptly to an obstetric facility for pelvimetry, ultrasound fetal weight estimation, and planning of elective or emergency C-section to prevent obstructed labour.

Cautions
  • RED FLAG - Uterine rupture: assess urgently and refer.
  • Suspected disproportion in active labour needs urgent obstetric management to avoid obstructed labour.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.