Hypotonic And Hypertonic Uterine Contraction

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.