A primigravida at 40 weeks of gestation is having uterine contractions every 1½ to 2 minutes 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
What is the likely status of this woman's labor? 1. She is exhibiting hypotonic uterine dysfunction.
2. She is experiencing a normal latent stage.
3. She is exhibiting hypertonic uterine dysfunction.
4. She is experiencing pelvic dystocia.
3
1. Incorrect. 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.
2. Incorrect. The contraction pattern seen with this woman is signifying hypertonic uterine activity. Typically, uterine activity in this phase occurs at 4- to 5-minute intervals lasting 30 to 45 seconds.
3. Correct. The woman experiencing hypertonic uterine dysfunction, or primary dysfunc-tional labor, often is an anxious first-time mother who is having painful and frequent contrac-tions that are ineffective in causing cervical dilation or effacement to progress.
4. Incorrect. Pelvic dystocia can occur whenever there are contractures of the pelvic diame-ters that reduce the capacity of the bony pelvis, including the inlet, midpelvis, outlet, or any combination of these planes.
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