2. Causes of Dystocia

what is hypertonic uterine dysfunction?

painful, poorly coordinated contractions with inadequate relaxation between them

• little cervical dilation despite frequent contractions

in hypertonic uterine dysfunction, inadequate uterine relaxation _____ placental blood flow and reduces fetal oxygenation

reduces ↓

what is hypotonic uterine dysfunction?

weak, ineffective contractions that do not adequately dilate and efface the cervix

what postpartum complication is associated with hypotonic uterine dysfunction?

postpartum hemorrhage

• the uterus may not contract effectively to compress blood vessels

what are protracted labor disorders?

slower-than-normal cervical dilation or fetal descent

what are arrest disorders?

cervical dilation or fetal descent stops

what is precipitate labor?

birth occurs less than 3 hours after contractions begin

• maternal cervical or perineal lacerations

• fetal birth trauma or hypoxia

what is pelvic contraction?

narrowing of the pelvic muscles that can interfere with fetal descent

what is soft tissue dystocia?

soft tissue obstruction in the birth canal that interferes with fetal descent

• examples include swelling of the cervix or surrounding tissues

passenger problems

• occiput posterior position

• breech presentation

• multi fetal pregnancy

• macrosomnia

• cephalopelvic disproportion (head too big for pelvis)

• structural anomalies

how can an occiput posterior position interfere with labor?

it can make fetal rotation and descent more difficult

• lower-back pain is common

why can breech presentation complicate birth?

the buttocks or feet deliver before the head, increasing the risk of cord compression and head entrapment

what is cephalopelvic disproportion (CPD)?

the fetal head is too large to pass through the maternal pelvis

how can psychological distress interfere with labor?

stress hormones can disrupt coordinated uterine contractions

what should the nurse assess when labor is not progressing?

• history of risk factors

• maternal emotional state

• vital signs

• uterine contractions

• fetal heart rate and position

how can the nurse help promote labor progress during dystocia?

encourage position changes and walking when appropriate

how can the nurse support a patient experiencing dystocia?

• provide physical comfort and emotional reassurance

• explain what is happening

• involve the patient in decisions