3.3 - Hyperstimulation Flashcards
Describe the difference between hypertonus, tachysystole and hyperstimulation.
- Tachysystole is a uterine contraction rate of more than 5:10 active labour contractions within 10 minutes
without fetal heart rate abnormalities - Uterine hypertonus is contractions lasting longer than 2 minutes or occurring within 60 seconds of each other
without fetal heart rate abnormalities - Uterine hyperstimulation is tachysystole or uterine hypertonus with fetal heart rate abnormalities
What is the normal SpO2 for a well oxygenated fetus?
In uncompromised and adequately breathing infants, SpO2 increases from 50–60% in the fetus
What are the effects over 30 minutes to fetal SpO2 when contractions are 5:10 , 6 or >:10.
What implications does this have on your midwifery management of labour?
What are the implications to the fetus and potentially the mother when uterine activity is excessive?
How are these conditions of uterine abnormal action managed?
Melanie a multigravida being induced for postdates and has continuous fetal monitoring. It is noted she is contracting 6 in 10 with contractions lasting 45 seconds with resting time of 45 seconds, fetal heart rate pattern is normal. This demonstrates which aspects of excessive uterine activity?
Tachysystole and hypertonus
Cervical Dystocia
failure of the cervix to dilate despite presence of uterine contractions
Precipitate Labour
expulsion of the fetus within 3 hours of the commencement of contractions
Obstructed labour
despite effective uterine contractions, there is no advance of the presenting part.
Bandl’s ring
is an exaggerated retraction ring seen as an oblique ridge between the upper and lower segments. This is a sign of obstructed labour.
Obstetric Fistula
Is an abnormal opening (usually as a result of ruptured tissues) between the:
Vagina and the urinary bladder, Vagina and rectum, Vagina and urethra, Vagina and ureter.
Incoordinate labour
Defective polarity between the upper and lower segments of the uterus, resulting in inefficient, ineffective uterine action that causes prolongation of labour.
Sui a multigravida being induced for postdates and has continuous fetal monitoring. It is noted she is contracting 4 in 10 with contractions lasting 90 seconds with resting time of 40 seconds, fetal heart rate pattern is normal. This demonstrates which aspects of excessive uterine activity?
Hypertonus
Chen a multigravida being induced for postdates and has continuous fetal monitoring. It is noted she is contracting 5 in 10 with contractions lasting 60 seconds with resting time of 40 seconds, fetal heart rate pattern is abnormal. This demonstrates which aspects of excessive uterine activity?
Hyperstimulation
On an intrapartum vaginal examination of a woman in the active phase of labour, four hours after a previous examination, despite uterine activity being assessed as effective, you find that the presenting part has not descended, the presenting part is poorly applied to the cervix with significant moulding and caput and the cervix has not dilated any further. The likely reason for these findings is
obstructed labour
On an abdominal palpation of a woman in the active phase of labour, you note an oblique ridge running across her abdomen, that was not noted on previous abdominal examination. The likely reason for this finding is
obstructed labour
While assessing a woman in the active phase of labour, you note her to be tachycardic, pyrexic and her urinary catheter bag to contain blood stained urine. The most likely reason
obstructed labour
