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Difference Between Constriction and Retraction Rings

 

Constriction Ring (Schroeder's Ring)

Retraction Ring (Bandl's Ring)

Nature

It is a manifestation of localized

In coordinate uterine contraction

It is an end result of tonic uterine contraction and retraction

Cause

Undue irritability of the uterus

Following obstructed labor

Situation

Usually at the junction of upper and lower segment but may occur in other places.

The position does not alter

Always situated at the junction of upper and lower segment. The position progressively moves upward

Uterus

Upper segment contracts and retracts

with relaxation in between, lower segment

remains thick and loose

Upper segment is tonically contracted with no relaxation. The wall becomes thicker; lower segment becomes distended and thinned out

Maternal condition

Almost unaffected unless the labor is prolonged

Maternal distress is invariably present

Abdominal examination

 

1. Uterus feels normal and not tender

2. Fetal parts are easily felt

3. Ring is not felt

4. Round ligament is not felt

5. FHS is usually present

1. Uterus is tense and tender

2. Not easily felt

3. Ring is felt as a groove placed

obliquely

4. Taut and tender round ligaments are felt

5. FHS is usually absent

Vaginal

examination

1. The lower segment is hot pressed by the

presenting part

2. Ring is felt usually above the head

3. Features of obstructed labor are absent

1. Lower segment is very much pressed

by the forcibly driven presenting part

2. Ring cannot be felt vaginally

3. Features of obstructed labor are present

End result

1. Exhaustion to the mother is a late feature

2. Fetal anoxia due to prolonged uterine

hypertonic state may appear late

3. Chance of uterine rupture is absent

1. Exhaustion and sepsis appear early

2. Fetal death is usually early due to tonic contraction and exaggerated retraction

3. Ruptured uterus in multigravidas and uterine exhaustion in primigravidas are the common mode to terminations

Principle of

treatment

To relax the ring followed by delivery of the

baby

To relieve the obstruction by safe procedure after excluding ruptured uterus





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