refers to labor that does not progress with dilatation or effacement of the cervix and fetal descent.
is aterm used to describe any difficult labor or birth. Occurs in approx. 8% - 11% of deliveries. And is most common.
(Poor UCs) may be from analgesics/anesthesia, exhaustion
(small pelvic inlet/outlet) CPD, placenta previa, full bladder/rectum.
(malpresentations:breech, brow or transverse, shoulder dystocia/LGA), multiple fetuses.
restricting mother to supine or lithotomy position .
position in labor can prolong labor
Though helpful for fetal monitoring but place pressure on the inferior vena cava which depresses maternal cardiac output and therefore placental perfusion. In this position the pelvis is less mobile and the axis of the uterus is on the symphysis pubis and not at the pelvic inlet. This can delay the descent, rotation and expulsionof the fetus.
Hypertonic Uterine Dysfunction
rule out malpresentation, CPD. Increased number of UC w/out adequate relaxation (high resting tone) to allow the fetus to maintain O2 reserve = fetal distress or rupture of uterus from tetanic contractions. Painful, tiring labor with no or little progress. Usually in the latent phase of labor.
Hypotonic Uterine Dysfunction
Rule out malpresentation or CPD. Decreased number of UC, irregular and ineffective = slowing or stopping of progress. Usually occuring during active pahse of labor. Amniotomy or augmentation with oxytocin are usually required. Reposition mother to facilitate fetal descent.
May be used to augment the strength of the UC if they are of inadeuqate force.