uterine contraction discoordination

Question 1

definition and etiology

Answer 1

• abN in coordination of uterine contractility that prevents the normal progress of labour

Question 2

classification

Answer 2

• can be divided into 3 :-
  i) Hypotonic dysfunction
• contraction with insufficient force ( < 24 mmHg ), irregular or infrequent rhythm or both
• seen mostly in primagravida in active phase of labour
• maybe dt excessive sedative, early admin of conduction anesthesia, twins, polyhydramnions, or overdistension of uterus
• inadequate pushing in 2nd stage of labour is common and maybe caused by conduction anesthesia, oversedative, exhaustion, or neurologic dysfunction or psychiatric disorder

ii) Hypertonic dysfunction

iii) Uncoordinated dysfunction
- less common than hypoT dysfunction
- often occur together with uncoordinated dysfunction
- characterized by elevated resting tone of uterus, dyssynchronous contractions with elevated one in lower uterine segment instead of normally fundus localization
- generally associated with abruption placentae, overzealous use of oxytoxin, cephalopelvic disproportion, fetal malpresentation and latent phase of labour

Question 3

complications

Answer 3

• Hypertonic labour may cause precipitate labor disorders, resulting fetal intracranial hemorrhage, fetal distress, neonatal injury or depression and birth canal laceration fr rapid delivery
• Hypotonic dysfunction may cause delayed process of labour and results fetal distress ( lead to fetal intoxication by feaces ), hypoxia ( affection of CNS ), or even IU death.

Question 4

prophylaxis

Answer 4

• control the amount of oxytoxin infusion to prevent hypoT or hyperT dysfunction
• prevent too early admin of anesthetic
• regular scanning to confirm lie and presentation of baby to prevent malpresentation and cephalopelvic disproportion