Hypotonic And Hypertonic Uterine Contraction

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Hypotonic And Hypertonic Uterine Contraction

The difference between Hypotonic and Hypertonic Uterine Contraction


Hypotonic uterine contraction ( inertia ):

Hypotonic labor is defined as less than 3 contractions of mild to moderate intensity occurring in a 10 minute period during the active phase of labor.

Cervical dilatation and descent of the fetus slow greatly or stop.

Etiology:

  • Such labor occurs when uterine fibers are overstretched from large baby, twins, hydramnios or multiparty.
  • May also caused by administration of sedation or narcotics.
  • Bowel or bladder distention.

Potential maternal effects:

  • Exhaustion.
  • Infection.
  • Postpartum hemorrhage.
  • Stress and psychological trauma.

Potential fetal effects:

  • Fetal sepsis ( infection).
  • Fetal and neonatal death.

Medical management:


Oxytocic stimulation of labor or prostaglandin stimulation.

Hypertonic uterine contraction:

  • Occurs in the latent phase of labor, with an increase in the frequency of contractions and a decrease in their intensity.
  • Contractions are extremely painful because of uterine muscle cell anoxia but are ineffective in dilating and effacing the cervix, which leads to maternal exhaustion.
  • Contraction may interfere with uteroplacental exchange and lead to fetal distress and even death.
  • Contractions may be uncoordinated and involve only portions of the uterus.
  • Usually occurs before 4 cm dilation, cause not yet known, may be related to fear tension.

Potential maternal effects:

  • Loss of control related to the intensity of pain and lack of progress.
  • Exhaustion.
  • Dehydration.

Potential fetal effect:


Fetal asphyxia with meconium aspiration death.

Medical management:


Analgesic (morphine, meperidine ) if membranes not ruptured fetopelvic disproportion isn’t present.

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