Which presentation is most likely to occur with a hypertonic labor pattern? (Select all that apply.)
a. Increased risk for placenta previa
b. Painful uterine contractions
c. Increased resting tone
d. Uterine vasodilation
e. Increased uterine pressure
f. Effective uterine contraction
ANS: B, C, E
Hypertonic labor patterns indicate increased uterine pressure and resting tone. Uterine ischemia occurs, leading to vasoconstriction and constant cramplike abdominal pain. Thus, there is an increased risk for placental abruption as compared with placenta previa, which is based on malpresentation of the placental attachment. The contractions are painful but not effective for progression of labor.
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