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.
2
Q
Def of Contraction
A
- Shortening of muscle in response to stimulus e return to its original length when contraction has passed.
3
Q
Defs in Abnormal Uterine Action
A
- Tonus
- Intensity
- Frequency
- Duration
- Uterine Activity
4
Q
Abnormal Uterine Action
- Tonus
A
- Resting intrauterine pressure () contractions ( normally = 8- 12 mmHg)
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).
6
Q
Abnormal Uterine Action
- Frequency
A
- Number of contractions per 10 minutes (normally = 3 - 5 / 10 minutes).
7
Q
Abnormal Uterine Action
- Duration
A
Duration of each contraction (normally = 60-80 sec).
8
Q
Abnormal Uterine Action
- Uterine Activity
A
Intensity x frequency (it is expressed in Montevideo unit)
9
Q
Physiological Criteria of Uterine Contractions
A
- Coordination
- Progressive
- Painful
- Polarity
- Retraction
- Involuntary
- Intermittent
- Effective
- Abolished by tocolytics
- Fundal Dominance
10
Q
Physiological Criteria of Uterine Contractions
- Involuntary
A
Smooth muscle contraction out of control.
11
Q
Physiological Criteria of Uterine Contractions
- Intermittent
A
Periods of contraction alternating e periods of relaxation.
12
Q
Physiological Criteria of Uterine Contractions
- Painful
A
13
Q
Causes of pain during uterine contractions
A
14
Q
- Lower abdominal pain is related to activity in ….. & is present during ……
A
- UUS
- efficient labor
15
Q
Back pain is related to tension in …… & ……
A
LUS & cervix
16
Q
Physiological Criteria of Uterine Contractions
- Progressive
A
Increase Gradually in frequency, duration & intensity.
17
Q
Physiological Criteria of Uterine Contractions
- Coordinated
A
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)
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).
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.
21
Q
Physiological Criteria of Uterine Contractions
- Effective (Fruitful)
A
Associated e cervical effacement & dilatation, descent of fetus & delivery of placenta.
22
Q
Physiological Criteria of Uterine Contractions
- Abolished by ….
A
tocolytic Drugs
23
Q
Methods of measurement of uterine activity during labor
A
- Clinical
- Electronic
24
Q
Methods of measurement of uterine activity during labor
- Clinical
A
25
Methods of measurement of uterine activity during labor
- Electronic
External or internal tocodynamometer
26
Classification of **Abnormal Uterine Action**
27
Classification of **Abnormal Uterine Action**
- Normal Polarity
28
Classification of **Abnormal Uterine Action**
- With abnormal polarity (incoordinate uterine action)
29
Def of **Hypotonic Uterine Inertia**
30
Types of **Hypotonic Uterine Inertia**
31
Etiology of **Hypotonic Uterine Inertia**
32
CP of **Hypotonic Uterine Inertia**
33
Complications of **Hypotonic Uterine Inertia**
34
Complications of **Hypotonic Uterine Inertia**
- Maternal
35
Complications of **Hypotonic Uterine Inertia**
- Fetal & Neonatal
36
TTT of **Hypotonic Uterine Inertia**
- Prophylactic
- General
- Uterine Stimulants
- AROM
- Operative Managment
37
TTT of **Hypotonic Uterine Inertia**
- Prophylactic
Reassurance of women & mental & physical rest during ANC.
38
TTT of **Hypotonic Uterine Inertia**
- General Measures
- Careful examination to exclude malpresentation & malposition & disproportion.
- Proper management of 1st stage of labor.
39
TTT of **Hypotonic Uterine Inertia**
- Uterine Stimulants
40
TTT of **Hypotonic Uterine Inertia**
- AROM
if vaginal delivery is amenable & cervix is > 3 cm dilatation.
41
TTT of **Hypotonic Uterine Inertia**
- Operative TTT
42
Def of **Precipitate Labor**
43
Types of **Precipitate Labor**
1ry & 2ry to oxytocin Stimulation
44
Etiology of **Precipitate Labor**
45
Complications of **Precipitate Labor**
46
Complications of **Precipitate Labor**
- Maternal
47
Complications of **Precipitate Labor**
- fetal & Neonatal
48
TTT of **Precipitate Labor**
49
TTT of **Precipitate Labor**
- before Labor
- Patient e previous precipitate labor should be hospitalized before EDD as she is more prone to repeated precipitate labor.
50
TTT of **Precipitate Labor**
- During Labor
51
TTT of **Precipitate Labor**
- After Labor
- Exploration of birth canal for lacerations & tears.
- Examination of neonate for injuries.
52
Types of **Hypertonic Uterine Inertia**
53
Types of **Hypertonic Uterine Inertia**
- 1ry hypertonic uterine inertia
Both UUS & LUS show measurable T in tone (it may be due to faulty or absent retraction).
54
Types of **Hypertonic Uterine Inertia**
- Hypertonic LUS (LUS Dominance)
- Due to reversed polarity (usually
associated e OP positions).
55
Types of **Hypertonic Uterine Inertia**
- Colicky Uterus (Uterine Fibrillation)
Due to appearance of new pacemakers' allover uterus.
56
Types of **Hypertonic Uterine Inertia**
- Generalized tonic contraction (uterine tetany)
57
CP of **Hypertonic Uterine Inertia**
58
TTT of **Hypertonic Uterine Inertia**
59
TTT of **Hypertonic Uterine Inertia**
- Propylactic
Avoid abuse of oxytocin or ergot.
60
TTT of **Hypertonic Uterine Inertia**
- General Measures
1. Careful examination to exclude malpresentation & malposition disproportion.
2. Proper management of pt stage of labor (see normal labor).
61
TTT of **Hypertonic Uterine Inertia**
- Medical Measures
Sedatives (as pethidine), antispasmodics or epidural analgesia
62
TTT of **Hypertonic Uterine Inertia**
- Operative
1. CS: If fetal distress occurs before full cervical dilatation.
2. Ventouse or forceps extraction: After full cervical dilatation.
63
Def of **Constriction (Contraction) Ring**
Persistent localized annular spasm of circular muscles of uterus.
64
PPT Factors for **Constriction (Contraction) Ring**
65
Time of Occurence of **Constriction (Contraction) Ring**
During any stage of labor.
66
Site of **Constriction (Contraction) Ring**
67
Complications of **Constriction (Contraction) Ring**
68
Dx of **Constriction (Contraction) Ring**
69
DDx of **Constriction (Contraction) Ring**
From pathological retraction ring
70
TTT of **Constriction (Contraction) Ring**
71
Compare between **Constriction (Schroeder's) Ring** & **Pathological retraction ring
(Band's ring)**
72
Compare between **Constriction (Schroeder's) Ring** & **Pathological retraction ring
(Band's ring)** in terms of:
- Pathogenesis
- Time
- Site
73
Compare between **Constriction (Schroeder's) Ring** & **Pathological retraction ring
(Band's ring)** in terms of:
- Position
- Examination
- Uterus Above
- Uterus Below
74
Compare between **Constriction (Schroeder's) Ring** & **Pathological retraction ring
(Band's ring)** in terms of:
- Presenting Part
- Obstructed Labor
75
Compare between **Constriction (Schroeder's) Ring** & **Pathological retraction ring
(Band's ring)** in terms of:
- Rupture Uterus
- Maternal & Fetal Distress
- TTT
76
Def of **Cervical Rigidity (Cervical Dystocia)**
- Failure of taking up & dilatation of cervix ein reasonable time in spite of good uterine contractions.
77
Etiology of **Cervical Rigidity (Cervical Dystocia)**
78
Complications of **Cervical Rigidity (Cervical Dystocia)**
79
TTT of **Cervical Rigidity (Cervical Dystocia)**
80
TTT of **Cervical Rigidity (Cervical Dystocia)**
- Functional rigidity
81
TTT of **Cervical Rigidity (Cervical Dystocia)**
- Organic Rigidity
CS is usually done if cervix doesn't dilate ein reasonable time.
82
Done
...
