Hypotonic And Hypertonic Uterine Contraction

Hypotonic And Hypertonic Uterine Contraction

Hypotonic uterine contraction ( inertia ):

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

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

Aetiology:

- Such labour occurs when uterine fibres 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 haemorrhage.

- Stress and psychological trauma.

Potential fetal effects:

- Fetal sepsis ( infection).

- Fetal and neonatal death.

Medical management:

Oxytocic stimulation of labour or prostaglandin stimulation.

Hypertonic uterine contraction:

- Occurs in the latent phase of labour, 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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