Abnormal Labour and Inefficient Action

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What methods can be employed to treat inefficient uterine contractions?

Maternal rehydration, artificial rupture of membranes, and intravenous oxytocin.

How are Montevideo Units (MVUs) calculated and what is considered adequate?

MVUs are calculated by multiplying the average peak strength of contractions (mmHg) by the number of contractions in 10 minutes; a total of >200 is considered adequate.

What contraction strength is necessary for cervical dilation to occur?

Each contraction must generate at least 25 mmHg, with 50-60 mmHg being optimal.

Which pelvic shape is considered most optimal for a normal delivery, and what are some other types?

The gynecoid pelvis is most optimal, while the android, anthropoid, and platypelloid shapes may lead to obstructed labor. Signup and view all the answers

What is pelvimetry and what does it assess?

Pelvimetry is the clinical estimation of the adequacy of the pelvis. Signup and view all the answers

What characterizes prolonged labor or dystocia?

Prolonged labor or dystocia is characterized by poor progress, which includes a delay in cervical dilation or descent of the fetal presenting part. Signup and view all the answers

What are the three variables that affect the progress of labor?

The three variables are the powers (uterine contractions), the passages (uterus, cervix, pelvis), and the passenger (the fetus). Signup and view all the answers

What is the significance of uterine contractions in the context of abnormal labor?

Uterine contractions are significant as inefficient actions are the most common cause of poor progress in labor, especially in primigravidae and older women. Signup and view all the answers

How is the efficiency of uterine contractions assessed?

Efficiency can be assessed through clinical examination (palpation), external tocography, or intrauterine pressure catheters (IUPC). Signup and view all the answers

What frequency of contractions is generally considered efficient during labor?

A frequency of 4 to 5 contractions per 10 minutes is usually considered efficient. Signup and view all the answers

What complications can arise from abnormal labor?

Complications can include fetal compromise, cervical tear, and ruptured uterus. Signup and view all the answers

In what scenarios might labor be considered precipitate?

Labor is considered precipitate when the onset to birth time is one hour or less. Signup and view all the answers

What factors might indicate malpresentation in labor?

Malpresentation can be indicated by abnormal fetal position, size, or if a uterine scar is present. Signup and view all the answers

Study Notes

Abnormal Labour

Prolonged labour is also known as dystocia or dysfunctional labour
Abnormal labour occurs when there is poor progress in cervical dilation or descent of the fetal presenting part, or when there is fetal compromise
Abnormal labour can be caused by malpresentation, malposition, a uterine scar, induced labour, or precipitate labour
Dystocia is defined as difficult or abnormally slow progressing labour
Labour progress is dependent on three variables known as "3Ps":
- The powers (efficiency of uterine contractions)
- The passages (uterus, cervix, and bony pelvis)
- The passenger (the fetus, particularly its size, presentation, and position)

Inefficient Uterine Action

The most common cause of poor progress in labour is inefficient uterine action
More common in primigravida and older women
Characterized by weak and infrequent contractions
Measured using:
- Clinical examination (palpation)
- External uterine tocography (tocodynamometer)
- Intrauterine pressure catheters (IUPC)
A frequency of 4 to 5 contractions per 10 minutes is usually considered efficient
Treatment for inefficient uterine contractions include:
- Maternal rehydration
- Artificial rupture of membranes (ARM)
- Intravenous oxytocin (syntocinon)

Montevideo Units (MVUs)

Calculated by multiplying the average peak strength of contractions (mmHg) by the number of contractions in 10 minutes
200 MVUs is considered "adequate"

The Passages

Abnormal bony pelvis can cause dystocia
Four types of pelves:
- Gynecoid (most optimal)
- Android
- Anthropoid
- Platypelloid
Pelvimetry is a clinical estimation of pelvic adequacy

Contracted Pelvic Inlet

Shortest AP diameter

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz focuses on the concepts of abnormal labour, including dystocia and inefficient uterine action. It covers the causes, characteristics, and factors affecting labour progress, such as the 3Ps: powers, passages, and passenger. Test your knowledge on the dynamics of childbirth and its complications.