DYSOTOCIA Flashcards
- The number of contractions are unusually infrequent.
- ACTIVE PHASE
- Not more than to 3 contractions in 10-minute period.
- LESS PAINFUL
- the strength of contractions does not arise above 25mmhg
- resting tone is less than 10mmgh
Hypotonic
- Resting tone is more than 15 mmHg
- Contractions are strong but not effective
LATENT PHASE: - Muscle fibers do not repolarize after contraction
- FETAL ANOXIA
- PAINFUL
Hypertonic
pacemaker of the contraction located
high of the uterus downwards
- More than one pacemaker that may contractions
- Receptor points are acting independently from the pacemaker
- patient has difficulty to rest in between contraction
INTERVENTION
Uncoordinated
- Contractions become ineffective during the 1st stage of labor.
- Longer than 14 hours in nullipara; more than 20 hours in multipara
- This may occur if the cervix is not “ripe” at the beginning of labor.
PROLONGED LATENT PHASE
- Cervical dilatation does not occur at 1.2 cm/h in nullipara or 1.5 cm/h multipara.
- Longer than 12 hours in primipara; 6 hours in multi para
- Fetal malformation or CPD
PROTRACTED ACTIVE PHASE
(pagbaba ni baby sa pelvic area or birth canal)
* Extends beyond 3 hours in nullipara; 1 hour in a multipara
* Most often results from abnormal fetal head position
*cesarean is required
PROLONGED DECELERATION PHASE
- Occurs if there is no progress in. cervical dilatation for longer than 2 hours
SECONDARY ARREST OF DILATATION
- Rate of descent is less than 1 cm/h in nullipara or 2 cm/h in multipara.
- Can be suspected if the 2nd stage of labor lasts over 2 hours in multipara
PROLONGED DESCENT
- No descent for 2 hours in nullipara or 1 hour in multipara
- Cephalopelvic Disproportion (CPD)
ARREST OF DESCENT
- Cervical dilatation occurs at a rate of 5 cm or more/hour in primipara or 10 cm or more/hour in multipara.
- Uterine contractions are so strong.
- Labor can be completed in less than 3 hours.
- Common in grand multiparity or after induction of labor via oxytocin
- Premature separation of placenta or laceration of the perineum
- Cannot be prevented but can be predicted.
PRECIPITATE LABOR
- Labor is started artificially
- Fetus is at term (over 39 weeks)
- Preeclampsia, eclampsia, severe HPN, DM, Rhi sensitization, PROM, intrauterine growth restriction, post-maturity
INDUCTION OF LABOR
- Assisting labor that has started spontaneously but not effective
- Uterine rupture or PROM
- Used cautiously with patients:
- Multiple gestation
- Polyhydramnios
- Grand parity
- With previous uterine scars
- 40 years old and above
AUGMENTATION OF LABOR
What should be the actions if:
- Fetus is in longitudinal line
- Cervix is ripe or ready for birth
- Vertex and engaged
- No CPD
- Over 39 weeks
- Induction of labor will be initiated
- Change in the cervical consistency from firm to soft.
- Dilatation and coordination of uterine contractions will not occur until this happened
CERVICAL RIPENING
3 METHOD TO RIPEN THE CERVIX:
Stripping (sweeping) the membranes
Hygroscopic suppositories
Insertion of prostaglandin
- Refers to the uterus turning inside out with either birth of the fetus or delivery of the placenta.
- It may occur if traction is applied to the umbilical cord to remove the placenta.
- Can cause large amount of blood suddenly gushes from the vagina.
- No uterine contractions
- Fundus is no longer palpable in the abdomen.
- Patient may begin to show signs of blood loss such as:
- Hypotension
- Dizziness
- Paleness
- Diaphoresis (excessive sweat)
INVERSION OF THE UTERUS
- 5 or more contractions in a 10 - minute period or contractions lasting more than 2 minutes in duration or occurring within 60 seconds of each other.
- Interferes with placenta filling and fetal oxygenation
HYPERSTIMULATION
DEGREE OF UTERINE INVERSION
- fundus inverts but does not herniate through the level of the internal os.
Incomplete
DEGREE OF UTERINE INVERSION
- the internal lining of the fundus crosses through the cervical os with no palpable fundus abdominally.
Complete
DEGREE OF UTERINE INVERSION
- entire uterus prolapsing through the cervix with the fundus
Prolapse
occurs when AF is foreced into an open uterine blood sinus after a membrane rupture or partial premature sepration of the placenta
amniotic fluid embolosim
- A loop of the umbilical cord slips down in front of the presenting fetal part.
- It may occur at any time after the membranes ruptures if the presenting fetal part is not fitted firmly into the cervix.
PROLAPSE OF THE UMBILICAL
- The fetus is not getting enough oxygenated blood from the placenta or umbilical cord
- FHR pattern may show variable decelerations
FETAL DISTRESS
