Hypertonic Uterine Contraction

Subject: Midwifery II (Theory)

Overview

Hypertonic uterine action is a condition in which the tone of the uterus is elevated during and between contractions, resulting in severe backache. The higher tonic state of the uterus can result from any of the following conditions: spastic lower uterine segment, colicky uterus, asymmetrical uterine contraction, constriction ring, or generalized tonic contractions of the uterus, and all of these states are referred to as incoordinate uterine action. Monitor vital signs, fluid intake, and urine output to detect abnormalities and avoid ketoacidosis. Even when the membranes are intact, hypertonic uterine contraction is exceedingly harmful to the fetus.

Hypertonic uterine action is a condition in which the tone of the uterus is elevated during and between contractions, resulting in significant back pain. The higher tonic state of the uterus can result from any of the following conditions: spastic lower uterine segment, colicky uterus, asymmetrical uterine contraction, constriction ring, or generalized tonic contractions of the uterus, and all of these states are referred to as incoordinate uterine action.

Signs and Symptoms

  1. Contractions are annoying RT uterine muscle anoxia, resulting in chronic cramping pain
  2. Cervical dilation and effacement do not occur.
  3. Prolonged dormancy. Maintain a depth of 2 to 3 cm. do not dilate as they should
  4. Fetal distress manifests early– uterine resting tone is elevated, reducing placental perfusion.
  5. Worried and discouraged

Treatment of Hypertonic Uterine Contractions

  • IncludeCOMFORT MEASURES
    Warm shower; Mouth Care; Imagery; Music; Backrub
  • Mild sedation
  • Bedrest
  • Hydration
  • Tocolytics to reduce high uterine tone

To coordinate Uterine Action

This is a uterine dysfunctional condition. Contractions are typically intense, painful, and/or frequent, although the cervix dilates slowly. The uterus's two poles do not work in unison (in coordination between two poles.)

Management

  1. Exclude CPD; if moderate to severe CPD is present, prepare the mother for cesarean delivery.
  2. Monitor vital signs, fluid intake, and urine output to detect abnormalities and avoid ketoacidosis.
  3. Every quarter-hour, FHS should be heard and recorded.
  4. To avoid dehydration, adequate liquids should be administered.
  5. Maintain a labor trial by oxytocin infusion, i.e. 2.5 units syntonins in 500 ml of 5% dextrose, and start at 10 drops/min.
  6. Even when the membranes are intact, hypertonic uterine contraction is exceedingly harmful to the fetus. The fetus is deprived of oxygen because uteroplacental circulation is reduced by the hypertonic state: hence, fetal status should be monitored on a regular basis, and fetal distress should be treated immediately by cesarean section.

References
Things to remember
  • This is characterized as hypertonic uterine activity, in which the tone of the uterus is elevated during and between contractions, resulting in severe backache.
  • The higher tonic state of the uterus can result from any of the following conditions: spastic lower uterine segment, colicky uterus, asymmetrical uterine contraction, constriction ring, or generalized tonic contractions of the uterus, and all of these states are referred to as incoordinate uterine action.
  • Hypertonic uterine contractions are characterized by painful contractions caused by uterine muscle anoxia, resulting in persistent cramping discomfort, poor cervix dilatation and effacement, a prolonged latent period, fetal distress, and other clinical characteristics.
  • Monitor vital signs, fluid intake, and urine output to detect abnormalities and avoid ketoacidosis.
  • For women, hypertonic uterine contractions are exceedingly harmful.
Questions and Answers

This syndrome, known as hypertonic uterine activity, causes a severe backache while the tone of the uterus is elevated both during and between contractions. The increased tonic state of the uterus can result from a variety of disorders, including colic, an asymmetrical contraction of the lower uterine segment, constriction rings, or generalized tonic contractions of the uterus. These conditions are all referred to as incoordinate uterine action.

Signs and Symptoms:

  • Painful contractions Anoxia of the uterine muscles, which results in persistent cramping
  • Cervical dilation and effacement do not take place.
  • Extended latent period. Maintain 2 to 3 cm. not dilating as you should
  • Early fetal discomfort is caused by increased uterine resting tone, which reduces placental perfusion.
  • Stressed out and defeated.

Management:

  • Exclude CPD, and if moderate to severe CPD is present, get the mother ready for a caesarean.
  • To identify an abnormal state early and avoid ketoacidosis, keep an eye on your vital signs, fluid consumption, and urine production.
  • At every interval of every quarter-hour, FHS should be heard and recorded.
  • Dehydration should be avoided by providing enough fluid.
  • Maintain a labor trial by infusing oxytocin at a rate of 10 drops per minute starting at 2.5 syntonins in 500 ml of 5% dextrose.
  • Even when the membranes are still in tact, hypertonic uterine contractions are exceedingly harmful to the developing fetus. The hypertonic state reduces utero-placental circulation, which deprives the fetus of oxygen. As a result, fetal status should be regularly evaluated, and if fetal distress is observed, the infant should be delivered via caesarean section.

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