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What happens when labor and delivery contractions are too close together

Nurses and doctors must into action when there's uterine tachysystole

When a pregnant woman goes to the labor and delivery unit of the hospital in labor, the standard of care requires continuous electronic fetal monitoring to keep a close eye on the baby’s well-being.

Electronic fetal monitoring equipment displays and prints two separate lines. The top line measures the fetal heart rate and the bottom line measures the mom’s uterine contractions. Well-trained labor and delivery registered nurses and OB/GYN (obstetrician) physicians can obtain a wealth of information by interpreting fetal monitoring strips.

One of the important things for nurses and physicians to be aware of is the potential for a dangerous condition called uterine tachysystole. Basically, this is a medical condition where the mom’s contractions are happening too quickly and not spaced far enough apart. Uterine tachysystole is defined as more than five contractions in a 10-minute period, averaged over 30 minutes.

Most often, it will be a labor and delivery nurse who first notices uterine tachysystole. This is because it’s the duty of the nursing staff to closely monitor the laboring mother and to keep the doctor informed of progress and problems.

When a registered nurse recognizes that a patient is in tachysystole, the standard of care requires, at a minimum, nursing interventions including repositioning the mother to her left side, starting supplemental oxygen, and boosting the intravenous (IV) fluids that are already being administered.

If these interventions don’t quickly correct uterine tachysystole into an acceptable contraction pattern, the standard of care requires the labor and delivery nurse to notify the physician. But notification isn’t enough. The nurse must update the doctor on the complete clinical picture and apply critical thinking to make recommendations for modification of the medical plan, which can include an expedited or emergency delivery.

The danger of uncontrolled uterine tachysystole is the stress it places on the baby. Labor and delivery nurses are trained to understand that these excessive, strong contractions have a direct influence on fetal oxygenation. During the contraction, there’s a decrease in blood flow to the uterus and placenta, where oxygen exchange occurs. When the uterus contracts too frequently, it can interrupt the exchange of oxygen across the placenta, which results in the baby not getting enough oxygen (fetal hypoxemia). This in turn, manifests itself as decelerations, drops in the fetal heart rate, as shown on fetal monitoring.

When a baby is deprived of oxygen, it can lead to devastating permanent brain injuries including cerebral palsy and hypoxic-ischemic encephalopathy (HIE).

If your baby has been seriously injured because of poor labor and delivery care, then you should consider immediately contacting a top-rated Houston, Texas medical malpractice lawyer with significant experience in handling these complex cases. Babies born with permanent brain injuries have expensive care needs and a medical negligence lawsuit may produce the funds necessary to provide it.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.

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