Maternity Nursing Q 186
Which of the following may happen if the uterus becomes overstimulated by oxytocin during the induction of labor?
A. Weak contraction prolonged to more than 70 seconds.
B. Tetanic contractions prolonged to more than 90 seconds.
C. Increased pain with bright red vaginal bleeding.
D. Increased restlessness and anxiety.
Correct Answer: B. Tetanic contractions prolonged to more than 90 seconds
Hyperstimulation of the uterus such as with oxytocin during the induction of labor may result in tetanic contractions prolonged to more than 90seconds, which could lead to such complications as fetal distress, abruptio placentae, amniotic fluid embolism, laceration of the cervix, and uterine rupture.
Option A: With some methods, the uterus can be overstimulated, causing it to contract too frequently. Too many contractions may lead to changes in the fetal heart rate, umbilical cord problems, and other problems.
Option C: Painless vaginal bleeding during the second or third trimester of pregnancy is the usual presentation in placenta previa. The bleeding may be provoked from intercourse, vaginal examinations, labor, and at times there may be no identifiable cause. On speculum examination, there may be minimal bleeding to active bleeding.
Option D: Synthetic oxytocin, also known as Pitocin, is frequently administered during delivery for the purpose of inducing labor and preventing excessive post-delivery bleeding. One might hypothesize, based on the role that natural oxytocin plays, that women receiving oxytocin might receive some degree of benefit from the peri-partum use of Pitocin; however, a recent study calls this hypothesis into question. This study used population-based data available through the Massachusetts Integrated Clinical Academic Research Database (MiCARD) in order to retrospectively examine the relationship between peripartum synthetic oxytocin administration and the development of depressive and anxiety disorders within the first year postpartum. While the authors expected to observe that women exposed to synthetic oxytocin in this cohort would have a reduced risk of postpartum depressive and/or anxiety disorders than those without any exposure, they actually found the opposite.