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14 Cards in this Set

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Hypotonic Dysfunction
Coordinated but weak
become less frequent and shorter in duration
Easily indented at peak, minimal discomfort because the cotractions are weak

Uterine Resting Tone:
Not elevated

Phase of Labor:
Active - typically occurs after 4cm dilation, more common than hypertonic dysfuntion

Therapeutic Mngmnt: Amniotomy,
oxytocin augmentation,
Hypertonic Dysfunction
Short and poor intensity but painfula nd cramplike

Uterine Resting Tone:
Higher than normal
Important to distinguish from abruptio placentae

Phase of Labor:
Latent - usually occurs before 4cm dilation
Less common than hypotonic dysfunction

Therapeutic Mngmnt:
Correct cause if identified, Light sedation to promote rest
Tocolytics to reduce high uterine tone & promote placental perfusion
General term that describes any difficult labor or birth
Possible Causes of Hypotonic Dysfunction
Maternal fatigue
Maternal Inactivity
Fluid & Electrolyte Imbalance
Ecvessive Analgesia or anesthesia
Maternal catecholamines secreted in response to stress or pain
Disporportion between the maternal pelvis and fetal presenting part
Uterine overdistenetion
Large Baby
8.8lb or more at birth
Shoulder Dystocia
Impactation of the shoulder above the maternal symphysis pubis
Rotation Abnormalities
Occiput posterior or occiput transverse

Solution: Pt on Hands & Knees
Mutlifetal Pregnancy
Uterine overdistention resulting:
Hypotonic dysfunction
Hypertonic dysfunction
Abnormal presentation of fetus
Premature Rupture of Membranes
Associated Conditiosn:
Infections of Vagina
Chorioamnionitis (related to Strep B)
Incompetent cervix or short cervical length
Fetal abnormalities
Weak Amniotic Sac
Recent Amniocentesis or cerclage
Recent sexual intercourse
Nutritional deficiencies
Previous preterm birth related to PROM
+ fetal fibronection results
Preterm Labor
Define: labor begins between weeks 20 to 37

Signs and Symptoms:
Uterine contractions that may or may not be painful
Sensation that the baby is freq "balling up"
Constant low backache
Pelvic pressure or feeling that baby is pushing down
Pain, discomfort or pressure in the vagina or thighs
Change or increase in vaginal discharge
"just feeling bad" or "coming down with something"
Predicting Preterm Birth
Cervical Lenght:
Short Cervix (<25mm)
allowing vaginal organisms into uterus weakening membranes

Fetal Fibronection:
Normally found in cervial and vaginal secretions until 16 to 20wks gestation & again at or near term
Magnesium Sulfate
is used to inhibit preterm labor

Criteria for continuation:
Urine output of atleast 30ml/hr
Presence of deep tendon reflexes
Respirations of 12 per minutes

Antidote: Calcim gluconate
1g IV push over 3min
Accelerating Fetal Lung Maturity
Corticosteriods to speed up development if birth before 34wks seems inevitable
Prolonged Pregnancy
lasts longer than 42 weeks

reduced amniotic fluid volumne (oligohydramnios) results in umbilical cord compression