The failure of the uterus to expel the fetus normally due to total or partial absence of contractions, though an unobstructed birth canal is called?

1. A

   Uterine retroversion

2. B

   Uterine prolapsed

3. C

   Uterine tetany

4. D

   Uterine inertia

Appeared in: AIIMS Raipur NO - 2019 (Shift-2)

Explanation

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• The question describes a condition where uterine contractions are absent or too weak to expel the fetus, even though the birth canal is clear.
• This specific pattern of ineffective, weak contractions is known as uterine inertia or hypotonic uterine dysfunction.
• In this condition, the uterine muscle fails to generate the necessary force for labor to progress, leading to prolonged or arrested labor.

Why Other Options Were Wrong

• Option A: Uterine retroversion is a positional anomaly where the uterus is tilted backward. It does not describe the functional ability of the uterine muscle to contract during labor.
• Option B: Uterine prolapse is the descent of the uterus into the vagina due to weakened pelvic support structures. It is a condition of pelvic organ support, not a disorder of labor contractions.
• Option C: Uterine tetany, or hypertonic uterine dysfunction, is the opposite of the condition described. It involves contractions that are excessively strong, prolonged, and frequent, without adequate uterine relaxation.

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Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Abnormalities of Uterine Contractions in Labor as background academic context rather than a clinical decision trigger.
• Recognizing uterine inertia is critical for nurses to prevent maternal exhaustion, postpartum hemorrhage, and fetal distress.
• Prompt identification allows for timely intervention, such as oxytocin augmentation, which can prevent the need for a cesarean section.
• What if the contractions were weak AND the birth canal was obstructed? This would be diagnosed as cephalopelvic disproportion (CPD). In this case, oxytocin augmentation would be contraindicated as it could lead to uterine rupture, and a cesarean section would be necessary.

How to Approach the Question

• First, break down the question stem to identify the key defining features: 1) failure to expel the fetus, 2) absent or weak contractions, and 3) an unobstructed canal.
• Next, define each of the given options based on your medical knowledge.
• Uterine retroversion is a positional issue.
• Uterine prolapse is a pelvic support issue.
• Uterine tetany involves hypertonic (excessively strong) contractions.
• Uterine inertia involves hypotonic (weak or absent) contractions.

Concept Tested & Keywords

• Concept Tested: Abnormalities of Uterine Contractions in Labor
• Stem keywords: failure of the uterus, expel the fetus, absence of contractions, unobstructed birth canal
• Lead-in keywords: is called
• Negative lead-in flag: false

Question ID

QEHEABAlrYGjiuToMTp2Zi

Copy ID

Reference Book

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 52-63

E6 Obstetrics Williams p. 30-50