Obstetrics Quiz: Uterine Dystocia and Contractions

Study Notes

Uterine Dystocia

Uterine dystocia: Abnormal labor pattern due to ineffective cervical dilation or fetal head descent.
Influences: Often related to the four P’s - power (contractions), passenger (fetal position), passageway (maternal pelvic shape), psyche (maternal stress).
Risk factors: Maternal exhaustion and epidural anesthesia impair effective pushing.

Hypertonic Contractions

Definition: Frequent, painful contractions that fail to cause cervical dilation.
Impact: Prolongs labor and may lead to fetal distress from reduced uteroplacental blood flow.
Nursing Actions:
- Promote rest to break contraction patterns.
- Pain management with morphine as needed.
- Encourage relaxation through warm showers and minimal interruptions.
- Ensure hydration for effective contractions and to prevent dehydration.

Hypotonic Contractions

Definition: Weak, infrequent contractions that do not sufficiently dilate the cervix.
Common in: Multiparous women; factors include fatigue, fear, or dehydration.
Nursing Actions:
- Encourage ambulation and position changes to stimulate uterine activity.
- Provide hydration to enhance contraction strength.
- Utilize oxytocin (Pitocin) as per protocol to augment labor.

First Stage vs. Second Stage Arrest Disorder

First Stage Arrest:
- Definition: Cervical dilation stops despite adequate contractions.
- Risks: Could lead to complications if not managed.
Second Stage Arrest:
- Definition: Failure of fetal descent during the pushing phase.
- Causes: May be due to fetal positioning, maternal fatigue, or pelvic size issues.

Fetal Presentations Leading to Dystocia (Malpresentations)

Occiput Posterior:
- Baby’s head directed towards the mother’s back.
- Impacts: Can prolong labor and increase intervention likelihood.
Face Presentation:
- Baby’s face presents first; larger head diameter causes complications.
- Requires careful monitoring or potential cesarean delivery.
Breech Presentation:
- Baby’s buttocks or feet present first, increasing risk of cord prolapse.
- May necessitate cesarean section for safe delivery.

Methods of Labor Induction

Purpose: Induction of labor (IOL) is the stimulation of contractions to start labor due to risks to mother or fetus.
Indication: Post-term pregnancy, preeclampsia.
Methods:
- Cervical preparation using mechanical (balloon catheter) or pharmacological means (misoprostol, cervidil).
- Use of oxytocin (Pitocin) to stimulate contractions.
- Amniotomy (AROM) to rupture membranes for labor induction/augmentation.

Bishop Score

Definition: A scoring system that evaluates cervical readiness for labor.
Score indications:
- Score >8 signifies a high likelihood of successful induction.
- A lower score indicates decreased readiness and potential challenges for labor initiation.

Description

Test your knowledge on uterine dystocia, hypertonic, and hypotonic contractions. This quiz covers the definitions, risk factors, and nursing actions related to abnormal labor patterns. Delve into the important influences on labor to enhance your understanding of this critical aspect of obstetrics.