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Y4R2 - Obstetrics I 🤰 > L6: Abnormal Uterine Contractions > Flashcards

L6: Abnormal Uterine Contractions Flashcards

1
Q

Def of Abnormal Uterine Action

A
  • Abnormality in contractile pattern of uterine musculature that prevents normal progress of labor.
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2
Q

Def of Contraction

A
  • Shortening of muscle in response to stimulus e return to its original length when contraction has passed.
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3
Q

Defs in Abnormal Uterine Action

A
  • Tonus
  • Intensity
  • Frequency
  • Duration
  • Uterine Activity
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4
Q

Abnormal Uterine Action

  • Tonus
A
  • Resting intrauterine pressure () contractions ( normally = 8- 12 mmHg)
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5
Q

Abnormal Uterine Action

  • Intensity
A
  • Increase in intrauterine pressure above tonus brought about by each contraction
  • (normally = 40-80 mmHg in 1st stage & 100- 150 mmHg in 2nd stage).
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6
Q

Abnormal Uterine Action

  • Frequency
A
  • Number of contractions per 10 minutes (normally = 3 - 5 / 10 minutes).
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7
Q

Abnormal Uterine Action

  • Duration
A

Duration of each contraction (normally = 60-80 sec).

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8
Q

Abnormal Uterine Action

  • Uterine Activity
A

Intensity x frequency (it is expressed in Montevideo unit)

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9
Q

Physiological Criteria of Uterine Contractions

A
  • Coordination
  • Progressive
  • Painful
  • Polarity
  • Retraction
  • Involuntary
  • Intermittent
  • Effective
  • Abolished by tocolytics
  • Fundal Dominance
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10
Q

Physiological Criteria of Uterine Contractions

  • Involuntary
A

Smooth muscle contraction out of control.

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11
Q

Physiological Criteria of Uterine Contractions

  • Intermittent
A

Periods of contraction alternating e periods of relaxation.

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12
Q

Physiological Criteria of Uterine Contractions

  • Painful
A
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13
Q

Causes of pain during uterine contractions

A
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14
Q
  • Lower abdominal pain is related to activity in ….. & is present during ……
A
  • UUS
  • efficient labor
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15
Q

Back pain is related to tension in …… & ……

A

LUS & cervix

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16
Q

Physiological Criteria of Uterine Contractions

  • Progressive
A

Increase Gradually in frequency, duration & intensity.

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17
Q

Physiological Criteria of Uterine Contractions

  • Coordinated
A
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18
Q

Physiological Criteria of Uterine Contractions

  • Fundal Dominance
A
  • Maximum duration & intensity of contraction is at fundus (due to presence of pacemaker at cornu)
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19
Q

Physiological Criteria of Uterine Contractions

  • Polarity
A
  • When UUS contracts & retracts, LUS relaxes & dilates (actually, lower part contracts but much less than upper part).
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20
Q

Physiological Criteria of Uterine Contractions

  • Retraction
A
  • Shortening of muscle in response to stimulus but doesn’t return to its original length when contraction has passed.
  • Retraction occurs in UUS & is responsible for fetal descent & control of postpartum bleeding.
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21
Q

Physiological Criteria of Uterine Contractions

  • Effective (Fruitful)
A

Associated e cervical effacement & dilatation, descent of fetus & delivery of placenta.

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22
Q

Physiological Criteria of Uterine Contractions

  • Abolished by ….
A

tocolytic Drugs

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23
Q

Methods of measurement of uterine activity during labor

A
  • Clinical
  • Electronic
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24
Q

Methods of measurement of uterine activity during labor

  • Clinical
A
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25
Q

Methods of measurement of uterine activity during labor

  • Electronic
A

External or internal tocodynamometer

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26
Q

Classification of Abnormal Uterine Action

A
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27
Q

Classification of Abnormal Uterine Action

  • Normal Polarity
A
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28
Q

Classification of Abnormal Uterine Action

  • With abnormal polarity (incoordinate uterine action)
A
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29
Q

Def of Hypotonic Uterine Inertia

A
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30
Q

Types of Hypotonic Uterine Inertia

A
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31
Q

Etiology of Hypotonic Uterine Inertia

A
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32
Q

CP of Hypotonic Uterine Inertia

A
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33
Q

Complications of Hypotonic Uterine Inertia

34
Q

Complications of Hypotonic Uterine Inertia

  • Maternal
35
Q

Complications of Hypotonic Uterine Inertia

  • Fetal & Neonatal
36
Q

TTT of Hypotonic Uterine Inertia

A
  • Prophylactic
  • General
  • Uterine Stimulants
  • AROM
  • Operative Managment
37
Q

TTT of Hypotonic Uterine Inertia

  • Prophylactic
A

Reassurance of women & mental & physical rest during ANC.

38
Q

TTT of Hypotonic Uterine Inertia

  • General Measures
A
  • Careful examination to exclude malpresentation & malposition & disproportion.
  • Proper management of 1st stage of labor.
39
Q

TTT of Hypotonic Uterine Inertia

  • Uterine Stimulants
40
Q

TTT of Hypotonic Uterine Inertia

  • AROM
A

if vaginal delivery is amenable & cervix is > 3 cm dilatation.

41
Q

TTT of Hypotonic Uterine Inertia

  • Operative TTT
42
Q

Def of Precipitate Labor

43
Q

Types of Precipitate Labor

A

1ry & 2ry to oxytocin Stimulation

44
Q

Etiology of Precipitate Labor

45
Q

Complications of Precipitate Labor

46
Q

Complications of Precipitate Labor

  • Maternal
47
Q

Complications of Precipitate Labor

  • fetal & Neonatal
48
Q

TTT of Precipitate Labor

49
Q

TTT of Precipitate Labor

  • before Labor
A
  • Patient e previous precipitate labor should be hospitalized before EDD as she is more prone to repeated precipitate labor.
50
Q

TTT of Precipitate Labor

  • During Labor
51
Q

TTT of Precipitate Labor

  • After Labor
A
  • Exploration of birth canal for lacerations & tears.
  • Examination of neonate for injuries.
52
Q

Types of Hypertonic Uterine Inertia

53
Q

Types of Hypertonic Uterine Inertia

  • 1ry hypertonic uterine inertia
A

Both UUS & LUS show measurable T in tone (it may be due to faulty or absent retraction).

54
Q

Types of Hypertonic Uterine Inertia

  • Hypertonic LUS (LUS Dominance)
A
  • Due to reversed polarity (usually
    associated e OP positions).
55
Q

Types of Hypertonic Uterine Inertia

  • Colicky Uterus (Uterine Fibrillation)
A

Due to appearance of new pacemakers’ allover uterus.

56
Q

Types of Hypertonic Uterine Inertia

  • Generalized tonic contraction (uterine tetany)
57
Q

CP of Hypertonic Uterine Inertia

58
Q

TTT of Hypertonic Uterine Inertia

59
Q

TTT of Hypertonic Uterine Inertia

  • Propylactic
A

Avoid abuse of oxytocin or ergot.

60
Q

TTT of Hypertonic Uterine Inertia

  • General Measures
A
  1. Careful examination to exclude malpresentation & malposition disproportion.
  2. Proper management of pt stage of labor (see normal labor).
61
Q

TTT of Hypertonic Uterine Inertia

  • Medical Measures
A

Sedatives (as pethidine), antispasmodics or epidural analgesia

62
Q

TTT of Hypertonic Uterine Inertia

  • Operative
A
  1. CS: If fetal distress occurs before full cervical dilatation.
  2. Ventouse or forceps extraction: After full cervical dilatation.
63
Q

Def of Constriction (Contraction) Ring

A

Persistent localized annular spasm of circular muscles of uterus.

64
Q

PPT Factors for Constriction (Contraction) Ring

65
Q

Time of Occurence of Constriction (Contraction) Ring

A

During any stage of labor.

66
Q

Site of Constriction (Contraction) Ring

67
Q

Complications of Constriction (Contraction) Ring

68
Q

Dx of Constriction (Contraction) Ring

69
Q

DDx of Constriction (Contraction) Ring

A

From pathological retraction ring

70
Q

TTT of Constriction (Contraction) Ring

71
Q

Compare between Constriction (Schroeder’s) Ring & Pathological retraction ring
(Band’s ring)

72
Q

Compare between Constriction (Schroeder’s) Ring & Pathological retraction ring
(Band’s ring) in terms of:

  • Pathogenesis
  • Time
  • Site
73
Q

Compare between Constriction (Schroeder’s) Ring & Pathological retraction ring
(Band’s ring) in terms of:

  • Position
  • Examination
  • Uterus Above
  • Uterus Below
74
Q

Compare between Constriction (Schroeder’s) Ring & Pathological retraction ring
(Band’s ring) in terms of:

  • Presenting Part
  • Obstructed Labor
75
Q

Compare between Constriction (Schroeder’s) Ring & Pathological retraction ring
(Band’s ring) in terms of:

  • Rupture Uterus
  • Maternal & Fetal Distress
  • TTT
76
Q

Def of Cervical Rigidity (Cervical Dystocia)

A
  • Failure of taking up & dilatation of cervix ein reasonable time in spite of good uterine contractions.
77
Q

Etiology of Cervical Rigidity (Cervical Dystocia)

78
Q

Complications of Cervical Rigidity (Cervical Dystocia)

79
Q

TTT of Cervical Rigidity (Cervical Dystocia)

80
Q

TTT of Cervical Rigidity (Cervical Dystocia)

  • Functional rigidity
81
Q

TTT of Cervical Rigidity (Cervical Dystocia)

  • Organic Rigidity
A

CS is usually done if cervix doesn’t dilate ein reasonable time.

82
Q

Done

Y4R2 - Obstetrics I 🤰 (59 decks)

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