PROBLEMS

WITH THE
POWER 1
DYSTOCIA

long, difficult, or abnormal labor

Inertia
sluggishness of contractions or
slow force of labor
Classifications:
1. primary = occurring at the onset
Common Causes of Dysfunctional
1. Inappropriate use of analgesia
Labor
2. narrowed the pelvic diameter
3. Poor fetal position, malpresentation, Large fetus(over
4000 grams)
4. Extension rather than exion of the fetal head
5. Overdistention of the uterus
6. Cervical rigidity (unripe)
7. full rectum or urinary bladder
8. Maternal exhaustion
Maternal risks:
prolonged or nonprogressive labor, pain, fatigue,
dehydration
infection
Traumatic operative births

Fetal risks:
Hypoxia
Fetal distress
Birth injuries
DYSFUNCTIONAL LABOR

abnormal uterine contractions

that prevent the normal
progress of cervical dilation,
effacement (primary powers),
or descent (secondary powers).
Risk Factors:
Body build (e.g., 30 pounds or more overweight, short
stature)
Uterine abnormalities
Malpresentations and positions of the fetus
Cephalopelvic disproportion
Overstimulation with oxytocin
Maternal fatigue, dehydration and electrolyte imbalance,
and fear
Inappropriate timing of analgesic or anesthetic
administration
Ineffective Uterine Force

uterine contractions become

abnormal or ineffective
Hypotonic Uterine Contractions

Slow, infrequent uterine contractions

with decreased intensity during the
active phase of labor
< 2-3 contractions occurring within a
10-minute period
strength of contractions does not rise
above 25 mm Hg
uterus is easily indented even at the
Hypotonic Uterine Contractions
Causes:
1. Cephalopelvic disproportion
2. malpositions
3. administration of analgesia
4. bowel or bladder distention
5. overstretched uterus due to
multiple gestation
a large fetus
Hydramnios
grand multiparity.
Maternal Risks:
Postpartal hemorrhage
Maternal Exhaustion
Infection
Prolonged PROM
Psychologic trauma
Fetal Risks
Fetal infection
Fetal and neonatal death
Management:
ultrasound to rule out cephalopelvic disproportion
assess : fetal heart rate and pattern, characteristics of
amniotic fluid, and maternal well-being.
IV fluid therapy
nipple stimulation, and oxytocin infusion can be used to
augment the progress of labor
Assist with measures to enhance the progress of labor
(e.g., position changes, ambulation