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.