Tonic Uterine Contraction and Retraction (bandl’s ring)

Subject: Midwifery II (Theory)

Overview

This type of uterine contraction is most commonly caused by obstructed labor. The intensity, duration, and frequency of uterine contractions gradually rise. The relaxation period gets increasingly brief, and eventually, a state of tonic contraction occurs. In the first stage, circumferential dilatation narrowed the bottom portion. To accommodate the fetus propelled by the upper portion, the segment lengthens and becomes gradually thinner. Further retraction stops in primigravidae in reaction to blockage, and labor comes to a halt due to uterine weariness. Because of the constant pain and suffering, a mother gets exhausted and restless. It is a condition that can be avoided. In the antenatal stage, abnormalities caused by travel or passengers should be ruled out and necessary treatment should be planned. A damaging activity could be risk-free.

This type of uterine contraction is most commonly caused by obstructed labor. The intensity, duration, and frequency of uterine contractions gradually rise. The relaxation period gets increasingly brief, and eventually, a state of tonic contraction occurs. However, retraction persists. In the first stage, circumferential dilatation narrowed the bottom portion. To accommodate the fetus propelled by the upper portion, the segment lengthens and becomes gradually thinner. A pathological retraction ring refers to the formation of a circular groove around the uterus between the active upper segment and the swollen lower segment.

Further retraction stops in primigravidae in reaction to blockage, and labor comes to a halt due to uterine weariness. Contraction may resume with enhanced intensity after a brief period of rest, but in multigravidae, retraction persists with gradual circumferential dilatation and thinning of the lower segment. The bandl's ring rises gradually, getting closer and closer to the umbilicus and, eventually, rupturing the lower portion.

Signs and Symptoms

The mother feels tired and agitated as a result of the constant agony and discomfort.
There is evidence of fatigue and ketoacidosis.
Palpation of the abdomen reveals that the upper segment is firm, consistently convex, and painful.
The retraction ring is positioned obliquely between the umbilicus and the pubis symphysis.
Fetal parts may be poorly characterized.
FHS is frequently lacking.
A vaginal exam was revealed.
The vagina is dry and heated, with an irritating discharge.
Cervix completely dilated
The cause of blocked labor is discovered.

Management

Prevention: It is a condition that can be avoided. In the antenatal stage, abnormalities caused by travel or passengers should be ruled out and necessary treatment should be planned.
During labor, administer supportive therapy such as analgesia and sedative to keep the patient quiet.
Begin an IV drip with 5% dextrose.
Antibiotic prophylaxis will be administered to avoid subsequent infection.
Ketoacidosis and dehydration should be treated promptly and successfully with 5% dextrose and ringer's lactate.
Treatment that is definitive.
Exclude the possibility of uterine rupture.
A cesarean section is the safest option in advanced obstructed labor since a destructive procedure may rupture the uterus.

References

Tuitui, Roshani, and S. N. Dr. Suwal. Manual of Midwifery II (Intrapartum Care). Bhotahity, Kathmandu: Vidyarthi Pustak Bhandar, 2014.
https://wisesteps.wordpress.com/2011/11/01/normal-and-abnormal-uterine-contractions/
www.gfmer.ch/Obstetrics_simplified/abnormal_uterine_action.htm
https://www.slideshare.net/drpawanj/abnormal-uterine-action-22808834

Things to remember

This type of uterine contraction is most commonly caused by obstructed labor.
The intensity, duration, and frequency of uterine contractions gradually rise.
The relaxation phase gets shorter and shorter.
This type of uterine contraction is most commonly caused by obstructed labor.
The intensity, duration, and frequency of uterine contractions gradually rise.
The relaxation period gets increasingly brief, and eventually, a state of tonic contraction occurs.
However, retraction persists. In the first stage, circumferential dilatation narrowed the bottom portion.
To accommodate the fetus propelled by the upper portion, the segment lengthens and becomes gradually thinner.
Further retraction stops in primigravidae in reaction to blockage, and labor comes to a halt due to uterine weariness.
Because of the constant pain and suffering, a mother gets exhausted and restless.
Other signs and symptoms of tonic uterine contraction include abdominal palpation, which exposes an upper segment that is hard, evenly convex, and sensitive. Fetal components may be poorly defined, and FHS is frequently lacking. and so forth. It is a condition that can be avoided.
In the antenatal stage, abnormalities caused by travel or passengers should be ruled out and necessary treatment should be planned.
In severe obstructed labor, a destructive operation may be safe, but it may rupture the uterus, therefore a cesarean section is the safest option.
As a result, a state of tonic contraction arises.
However, retraction persists. In the first stage, circumferential dilatation narrowed the bottom portion.
To accommodate the fetus propelled by the upper portion, the segment lengthens and becomes gradually thinner. Further retraction stops in primigravidae in reaction to blockage, and labor comes to a halt due to uterine weariness.
Because of the constant pain and suffering, a mother gets exhausted and restless.
Other signs and symptoms of tonic uterine contraction include abdominal probing revealing an upper segment that is hard, evenly convex, and sensitive, fetal components that are not well delineated, and FHS that is frequently absent. and so forth. It is a condition that can be avoided.
In the antenatal stage, abnormalities caused by travel or passengers should be ruled out and necessary treatment should be planned.
In advanced obstructed labor, a destructive procedure may be safe since it may rupture the uterus.

Questions and Answers

List the sign and symptolms of tonic uterine contraction?

Signs and Symptoms

Due to ongoing anguish and suffering, mother gets tired and restless.
Keto acidosis and signs of tiredness were seen.
An upper section that is palpable in the abdomen is rigid, consistently convex, and painful.
Between the symphysis pubis and umbilicus is where the retraction ring is positioned.
Undefined fetal components are possible.
FHS frequently skips class.
An examination of the cervix showed:
Vagina is hot and dry with unpleasant discharge.
Fully dilated cervix
The cause of labor obstruction is made known.

What are the management of tonic uterine contraction ?

Management:

It is a condition that is avoidable. In the prenatal stage, it is important to rule out any abnormalities that could be caused by passage or passengers and make treatment plans accordingly.
When giving birth, give supportive therapy:
To keep the patient calm, analgesics and sedative should be administered.
Dextrose 5% IV drip should be started.
Antibiotic prophylaxis is administered to stop subsequent infection.
Ketoacidosis and dehydration should be treated with 5% dextrose and ringer's lactate as soon as possible.
The only course of action is to rule out uterine rupture.
The safest delivery method is a caesarean section because destructive surgery, which could rupture the uterus, may be safe in advanced obstructed labor.