Understanding Hypertonic Uterine Inertia: Causes, Symptoms, and Solutions
List of pertinent details about ‘hypertonic uterine inertia’:
1. Hypertonic uterine inertia is defined as infrequent, weak, and short-duration uterine contractions.
2. The causes of hypertonic uterine inertia are unknown.
3. Factors that may be involved in hypertonic uterine inertia include primigravida (particularly elderly), anemia, nervousness, hormonal deficiencies, improper use of analgesics, uterine overdistension, developmental anomalies, myomas, malpresentations, malpositions, cephalopelvic disproportion, and a full bladder or rectum.
4. Hypertonic uterine inertia can be categorized as primary or secondary inertia.
5. Primary inertia occurs when weak contractions occur from the start of labor.
6. Secondary inertia occurs when contractions may initially be strong but become weak and inadequate to overcome an obstruction.
7. Clinical symptoms of hypertonic uterine inertia include prolonged labor, infrequent and weak contractions, slow cervical dilatation, intact membranes, and little impact on the fetus and mother apart from maternal anxiety.
8. Complications from hypertonic uterine inertia can include retained placenta and postpartum hemorrhage.
9. Diagnosis of hypertonic uterine inertia is done through tocography to measure uterine contractions and examination to detect any abnormalities.
10. Management of hypertonic uterine inertia may include proper management of the first stage of labor, prophylactic antibiotics in prolonged labor, amniotomy, and the use of oxytocin to stimulate contractions.
11. Operative delivery, such as vaginal delivery using forceps or vacuum, or caesarean section, may be necessary in cases of failure of other methods or complications.
12. Hypertonic uterine inertia is more common in primigravidae.
13. Management includes general measures such as analgesics and antispasmodics.
14. Constriction (contraction) ring is a persistent localized spasm of the uterine muscles that typically occurs at the junction of the upper and lower uterine segments.
15. The cause of constriction ring is unknown but may be associated with factors such as malpresentations, improper use of oxytocin, and intrauterine manipulations.
16. Complications of constriction ring can include prolonged first or second stage of labor and retained placenta and postpartum hemorrhage.
17. Two conditions discussed in the article are hypertonic uterine inertia and cervical dystocia.
18. Delivery of the fetus is the only way to relieve hypertonic uterine inertia.
19. Treatment for hypertonic uterine inertia includes excluding malpresentations, malposition, and disproportion, as well as the use of medication such as pethidine or deep general anesthesia and amyl nitrite inhalation.
20. Cervical dystocia is the failure of the cervix to dilate within a reasonable time despite regular uterine contractions.
21. There are two varieties of cervical dystocia: organic and functional dystocia.
22. Complications of cervical dystocia include annular detachment of the cervix, rupture of the uterus, and postpartum hemorrhage.
23. Management of organic dystocia is cesarean section.
24. For functional dystocia, pethidine and antispasmodics may be effective. If medical treatment fails or fetal distress develops, a cesarean section is performed.