Prolonged Labor

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Questions and Answers

What is a potential cause of hypotonic contractions during labor?

  • Insufficient amniotic fluid
  • Early administration of analgesia
  • Overdistention of the uterus (correct)
  • High resting tone of the uterus

When do hypotonic contractions tend to occur?

  • After the administration of analgesia
  • In the presence of a full rectum
  • During the active phase of labor (correct)
  • During the latent phase of labor

What is a characteristic of hypotonic contractions?

  • Frequent contractions occurring every 2-3 minutes
  • Strength of contractions rising above 25 mmHg
  • Unusually infrequent contractions (correct)
  • Resting tone of the uterus above 10mmHg

What can impede fetal descent during labor?

<p>Full rectum or urinary bladder (B)</p> Signup and view all the answers

What can lead to a nonripe cervix during labor?

<p>Inappropriate use of analgesia (C)</p> Signup and view all the answers

What is the recommended intervention for prolonged latent phase of labor?

<p>Providing adequate fluid for hydration (A)</p> Signup and view all the answers

What is a potential cause of protracted active phase during labor?

<p>Fetal malposition or cephalopelvic disproportion (D)</p> Signup and view all the answers

What is the characteristic of hypotonic contractions during labor?

<p>Mild contractions with inadequate relaxation in between (D)</p> Signup and view all the answers

When may hypotonic contractions tend to occur?

<p>If the uterus is in a hypertonic state (A)</p> Signup and view all the answers

What intervention may be necessary if the latent phase lasts longer than 20 hours in a nullipara?

<p>Artificial rupture of membrane and oxytocin infusion (C)</p> Signup and view all the answers

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Study Notes

Labor Dysfunction

  • Labor dysfunction can occur at any point in labor and can be classified as primary or secondary.
  • Prolonged labor is associated with a higher risk of maternal postpartum infection, hemorrhage, and infant mortality.

Causes of Dysfunctional Labor

  • Large fetus
  • Hypotonic or hypertonic uterine contractions
  • Uncoordinated contractions
  • Ineffective uterine force

Uterine Contractions

  • Uterine contractions are essential for moving the fetus in the birth canal
  • Contractions occur due to the interplay of:
    • Contractile enzyme (adenosine triphosphate)
    • Major electrolytes (calcium, sodium, potassium)
    • Specific contractile proteins (actin and myosin)
    • Hormones (epinephrine, norepinephrine, oxytocin, estrogen, progesterone)
    • Prostaglandins

Common Causes of Dysfunctional Labor

  • Primigravida (first-time pregnancy)
  • Cephalopelvic disproportion (e.g., in women with rickets) due to pelvic bone contraction, narrowing the pelvic diameter
  • Abnormal fetal position:
    • Posterior position instead of anterior position
    • Extension of the fetal head instead of flexion

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