A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman’s labor?

Explanation: Uterine hyperstimulation or hypertonic uterine dysfunction is a potential complication of labor induction. It is important to note that hyperactive uterine contraction disorders can occur in both spontaneous and induced labors. The incidence is usually higher in the latter situation and during augmentation of spontaneous labors with oxytocic agents.It can occur as either a series of single contractions lasting 2 minutes or more OR a contraction frequency of five or more in 10 minutes. Most of these abnormal contraction patterns involve an increase in the frequency of contractions and include biphasic (coupling), tachysystolic and tetanic contractions.

Uterine hyperstimulation may result negative fetal effects which include fetal heart rate abnormalities, uterine rupture, or placental abruption. It is usually treated by administering terbutaline.