![]() ![]() ![]() ![]() The woman may also obtain lacerations of the birth canal due to forceful birth.Subdural hemorrhage for the fetus may occur from the rapid release of pressure on the head.Grand multiparity facilitates this kind of labor, or it can also happen after induction of labor by oxytocin or amniotomy.Precipitate labor occurs when uterine contractions are so strong that a woman gives birth with only a few and rapidly occurring contractions. ![]() Oxytocin could also assist labor if there is no contraindication to vaginal birth.The most likely cause of arrest of descent in the second stage of labor is CPD, so cesarean birth is necessary.When no descent occurs for 1 hour in a multipara and 2 hours in a nullipara, there is an arrest of descent.A semi-Fowler’s position, squatting, kneeling, or more effective pushing may speed up the descent.Intravenous oxytocin may also be administered to induce the uterus to contract effectively.Encourage the woman to rest and increase her fluid intake.If the rate of descent is less than 1 cm/hr in a nullipara or 2.0 in a multipara, then there is prolonged descent of the fetus.Dysfunction during the second stage of labor involves prolonged descent and arrest of descent.In secondary arrest of dilatation, there is no progress with cervical dilatation for more than 2 hours, and then cesarean birth would be necessary.Cesarean birth would also be necessary in a prolonged deceleration phase.Oxytocin is prescribed during a protracted active phase to augment labor.Prolonged latent phase can be managed through helping the uterus to rest, providing adequate fluid for hydration and pain relief.Dysfunctional labor during the first stage involves prolonged latent phase, protracted active phase, prolonged deceleration phase, and secondary arrest of dilatation.Oxytocin administration can also be done to stimulate a more effective and consistent pattern of contractions with a better, lower resting tone.A fetal and uterine external monitor must be attached to the woman to assess the rate, pattern, resting tone, and fetal response to contractions for at least 15 minutes.It would be difficult for the woman to rest between contractions because they occur erratically.More than one pacemaker may be initiating contractions with uncoordinated contractions, or receptor points in the myometrium may be acting independently of the pacemaker.Explain to the woman and her partner that although the contractions are very strong, they are ineffective and are not achieving cervical dilatation.Cesarean birth would be necessary if there is late deceleration, an abnormally long first stage of labor or lack of progress with pushing.A uterine and fetal external monitor should be applied for at least 15 minutes to check the resting phase of the contractions and that the fetal pattern is not showing a late deceleration.The lack of relaxation between contractions may not allow optimal uterine artery filling that could lead to fetal anoxia.They are more painful than usual, and they make the woman frustrated with her breathing techniques because they are ineffective.Hypertonic contractions tend to occur more frequently and during the latent phase of labor.Hypertonic contractions are marked by an increase in resting tone to more than 15 mmHg.In the first hour after birth following a labor of hypotonic contractions, palpate the uterus and assess the lochia every 15 minutes to ensure that there are no postpartal hypotonic contractions and inadequate to halt bleeding.Hypotonic contractions increase the woman’s risk for postpartal hemorrhage.Hypotonic contractions occur after administration of analgesia, bowel or bladder distention, if the uterus is overstretched due to multiple gestation, a large fetus, hydramnios, or a uterus that is lax from grand multiparity.The strength of contractions does not rise above 10 mmHg, and they occur mostly during the active phase of labor.There are only two or three contractions occurring within a 10-minute period.The number of uterine contractions in hypotonic contractions is unusually slow or infrequent.Ineffective labor occurs when uterine contractions become abnormal or ineffective, as uterine contractions are the basic force behind moving the fetus through the birth canal. Practice Quiz: Care of the Woman with Complications during Labor. ![]()
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