HYPERTONIC UTERINE CONTRACTION (INTRAPARTUM)

DESCRIPTION

occurs frequently and most commonly in the latent phase

increase in resting tone to >15mmHg

Risk factors

nulliparous women are more subject to abnormal early labor

Types

colicky uterus

hyperactive lower uterine segment

cockily uterus

incoordination of the different parts of the uterus in contraction

Hyperactive lower uterine segment

dominance of the upper segment is lost

Clinical Picture

Prolonged labor

irregular and more painful uterine contrsctions

slow cervical dilation

premature rupture of membranes

fetal and maternal distress

Nursing actions

promote rest to try to break the pattern of frequent but ineffective uterine contractions

promote uterine rest

How to promote uterine rest

administration of pain medication

promotion of relaxation

warm shower or tub bath

quiet environment

minimal interruptions to allow for long period of sleep

More Nursing actions

hydrate the woman with IV or PO fluids if tolerated

assess FHR and UCs

evaluate labor progress w sterile vaginal exam

Inform woman and family of the progress of labor and explain interventions

inform the care provider of the woman’s response and progress in labor

medical management

evaluate labor progress

evaluate cause of labor dysfunction

hydrate to improve uterine perfusion and coordination of UCs

provide pain management to allow the woman to sleep and prevent exhaustion

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