Uterine Contraction Monitoring
Sujoy K. Guba in Bioengineering in Reproductive Medicine, 2020
Strength and frequency of uterine contractions (UC) are major determinants of the progress of labor. Uterine inertia prolongs labor and leads to both fetal and maternal distress. Management with the infusion of oxytocics is very popular and cesarean sections are also often indicated. Therefore monitoring of uterine contractions is essential. The time honored clinical method of assessment of the strength of the uterine contraction by palpation of the maternal abdomen is no doubt very reassuring to the mother but has considerable subjectivity. Even so, it is quite acceptable in most cases but in some deliveries better quantitated and continuous monitoring of the uterine contractions is required.
Abnormal Labour
Malik Goonewardene in Obstetric Emergencies, 2021
The journey through the maternal pelvis is the shortest trip a human being would ever possibly embark upon, but it is probably also the most hazardous. Evolution has led to fetuses with larger heads being born through smaller maternal pelves, and this has made natural childbirth increasingly difficult. Dystocia, dysfunctional labour and poor progress are terms used to describe an abnormal labour pattern that deviates from what is observed in the majority of women who undergo normal deliveries. The inclusion of references for the expected norms for the parameters that are documented facilitates the recognition and documentation of an abnormality. The power for labour to progress is provided by uterine contractions, with maternal expulsive efforts contributing during the active phase of second stage. A full bladder may hinder the progress of labour, and emptying the bladder may be all that is necessary for labour to progress in this case.
Physiology of Pregnancy
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal in Principles of Physiology for the Anaesthetist, 2020
This chapter reviews the physiological changes that occur during pregnancy and details the basis of physiological changes. The basal metabolic rate increases to 20% above non-pregnant levels at 36 weeks of pregnancy and then falls slightly to 15% above baseline levels at term. Significant cardiovascular changes occur within the first 8 weeks of pregnancy. Studies carried out on pregnant women found no changes in airway closure, closing capacity or flow–volume curves during pregnancy. Pregnancy is associated with increased coagulability and platelet turnover. Progressive dilatation of the renal pelvis, calyces and ureters begins from the second or third month of pregnancy, primarily due to obstruction of urine flow by the gravid uterus or dilated ovarian plexuses. The placenta produces endorphins and enkephalins that may be analgesic during pregnancy. Endorphin production increases significantly in proportion to the frequency and duration of uterine contractions during labour and delivery, but their role in pregnancy is not completely understood.
Application of atosiban in frozen-thawed cycle patients with different times of embryo transfers
Published in Gynecological Endocrinology, 2016
Ye He, Huan Wu, Xiaojin He, Qiong Xing, Ping Zhou, Yunxia Cao, Zhaolian Wei
This prospective cohort study aimed to examine the effects of atosiban, given before transfer of frozen-thawed embryo to women with different number of embryo transfer (ET) cycles. Atosiban treatment significantly increased implantation rate and clinical pregnancy rate in the third and more than three ET groups. However, there were no significant increases in the above parameters in the first and second ET groups. Our study showed that patients those who underwent the third or more than three ET cycles were inclined to higher uterine contractions and serum oxytocin level, thus atosiban treatment starting from the third ET cycle may be effective in improving embryo implantation. This is the first study to evaluate the optimal atosiban treatment window corresponding to the number of ET cycles of the patients.
Uterine contractions in asymptomatic pregnant women with a short cervix on ultrasound
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2005
Dawnette Lewis, Jacquelyn J. Pelham, Elisa Done, Hanita Sawhney, Mary Talucci, Vincenzo Berghella
Objective. To estimate the incidence of uterine contractions in asymptomatic pregnant women with a short cervix on transvaginal ultrasound. Methods. Asymptomatic women with a short cervix on transvaginal ultrasound between 14 and 236/7 weeks of pregnancy were instructed to undergo uterine monitoring immediately. Women without available tracings were excluded. Women with and without contractions were compared with regard to demographics, risk factors, and outcomes. Results. One hundred and one women with a short cervix and available tracings were identified. Eighty-six (85%) had contractions and 15 (15%) did not have contractions immediately after identification of the short cervix. The median number of contractions per hour per woman was 4 (range 0–31). These two groups did not differ in demographics, risk factors, or outcomes, except for the fact that 33% of women with contractions versus 73% of women without uterine contractions had a prior second trimester loss (p = 0.004). Conclusions. In this study, 85% percent of pregnant women with a short cervix on transvaginal ultrasound between 14 and 24 weeks of pregnancy are having asymptomatic uterine contractions. This information is important for further investigation of the short cervix and preterm delivery.
High uterine contraction rates in births with normal and abnormal umbilical artery gases
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2012
Emily Hamilton, Philip Warrick, Eric Knox, Daniel O’Keeffe, Thomas Garite
Objective: To determine if the incidence of high contraction (HC) rates and associated decelerations were different in term births with metabolic acidemia (MA) compared to those with normal gases (N) over the last 4 h of labor. Methods: MA included 316 babies with cord base deficits (BD) over 12 mmol/L N - 3,320 babies with BD under 8 mmol/L. HC rates were defined as >5/10 min. Results: One or more episodes of HC occurred in 43.7% of MA and 36.6% of N. (p = 0.015) In both groups the HC rates rose from about 1 in 30 patients at the beginning to 1 in 7 to 9 patients at the end. MA showed a different transition of the deceleration response over time. At the beginning the average ratio of decelerations to uterine contractions was similar in both groups but over the final 140 min MA showed a consistently higher ratio. Conclusions: Although HC rates were more frequent in the MA, it was not uncommon in N. On average MA showed more decelerations at every level of contractions and had a persistently higher level of decelerations per contraction for more than 2 h before birth.
Related Knowledge Centers
- Cervix Uteri
- Fetus
- Muscle Contraction
- Placenta
- Uterine Muscle
- Obstetric Labor
- Induced Labor