Secondary uterine contraction weakness describes an inadequate intensity and/or frequency of contractions after the woman has already been in labour for some time. In such cases, a disparity between the presenting part and the pelvis is probably the cause. In the case of a clear disparity, referral to a specialist is necessary. If there is a relative deficiency of endogenous uterotonic hormones and there is no clear disparity between the head and the pelvis, the membranes can be artificially ruptured. This frequently stimulates contraction activity. If this does not help sufficiently, additional stimulation is required, in other words a contraction-stimulating drug (oxytocin) needs to be administered via a drip. Specialist supervision is needed for this. However, the cause is often a lack of energy. For such cases, the administration of contraction-stimulating drugs is not the correct action. Therefore, in the event of secondary uterine contraction weakness, the exact cause should first be established.
Procedure
- Ensure the bladder is empty (catheterise if necessary). A full bladder can hinder the progression of parturition both mechanically and reflexively.
- Check the urine for the presence of acetone; ketone bodies are released when fat is metabolised in the absence of carbohydrates. If acetone is present:
- Provide the woman with carbohydrates in the form of sugar cubes or honey.
- If necessary, administer glucose via a drip.
For every prolonged birth, it is better to anticipate a potential lack of energy by administering carbohydrates.