A primigravida at 40 weeks of gestation is having uterine contractions every 1½ to 2 mi-nutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural

Question

What is the likely status of this woman's labor? a. She is exhibiting hypotonic uterine dysfunction.
b. She is experiencing a normal latent stage.
c. She is exhibiting hypertonic uterine dysfunction.
d. She is experiencing pelvic dystocia.

Answer 1

C

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A With hypotonic uterine dysfunction, the woman initially makes normal progress into the active stage of labor; then the contractions become weak and inefficient or stop altogether.
B The contraction pattern seen in this woman signifies hypertonic uterine activity. Typically uterine activity in this phase occurs at 4- to 5-minute intervals lasting 30 to 45 seconds.
C Women who experience hypertonic uterine dysfunction, or primary dysfunc-tional labor, often are anxious first-time mothers who are having painful and frequent contractions that are ineffective at causing cervical dilation or efface-ment to progress.
D Pelvic dystocia can occur whenever contractures of the pelvic diameters reduce the capacity of the bony pelvis, including the inlet, midpelvis, outlet, or any combination of these planes.