Abstract
Uterine tachysystole (TS) is a potentially significant intrapartum complication seen most commonly in induced or augmented labors but may also occur in women with spontaneous labor. When it occurs, maternal and perinatal complications can arise if not identified and managed promptly by obstetric care providers. Over recent years, new definitions of the condition have facilitated further research into the field, which has been synthesized to inform clinical management guidelines and protocols. We propose a set of recommendations pertaining to TS in line with contemporary evidence and obstetric practice.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol 2008;112:661–6.10.1097/AOG.0b013e3181841395Search in Google Scholar
2. American College of Obstetricians and Gynecologists. Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol 2009;114:192–202.10.1097/AOG.0b013e3181aef106Search in Google Scholar
3. Leduc D, Biringer A, Lee L, Dy J. Induction of labour. J Obstet Gynaecol Can 2013;35:840–57.10.1016/S1701-2163(15)30842-2Search in Google Scholar
4. Simpson KR, James DC. Effects of oxytocin-induced uterine hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. Am J Obstet Gynecol 2008;199:34.e1–5.10.1016/j.ajog.2007.12.015Search in Google Scholar
5. Bakker PC, Kurver PH, Kuik DJ, Van Geijn HP. Elevated uterine activity increases the risk of fetal acidosis at birth. Am J Obstet Gynecol 2007;196:313.e1–6.10.1016/j.ajog.2006.11.035Search in Google Scholar
6. McNamara H, Johnson N. The effect of uterine contractions on fetal oxygen saturation. Br J Obstet Gynaecol 1995;102:644–7.10.1111/j.1471-0528.1995.tb11403.xSearch in Google Scholar
7. Ahmed AI, Zhu L, Aldhaheri S, Sakr S, Minkoff H, Haberman S. Uterine tachysystole in spontaneous labor at term. J Matern Fetal Neonatal Med 2016;29:3335–9.10.3109/14767058.2015.1125463Search in Google Scholar
8. Bofill JA, Darby MM, Castillo J, Sawardecker SU, Magann EF, Morrison JC. Tachysystole following cervical ripening and induction of labor is not associated with adverse outcomes. Gynecol Obstet Invest 2017;82:487–93.10.1159/000452666Search in Google Scholar
9. Frey HA, Tuuli MG, Roehl KA, Odibo AO, Macones GA, Cahill AG. Can contraction patterns predict neonatal outcomes? J Matern Fetal Neonatal Med 2014;27:1422–7.10.3109/14767058.2013.866645Search in Google Scholar
10. Heuser CC, Knight S, Esplin MS, Eller AG, Holmgren CM, Manuck TA, et al. Tachysystole in term labor: incidence, risk factors, outcomes, and effect on fetal heart tracings. Am J Obstet Gynecol 2013;209:32.e1–6.10.1016/j.ajog.2013.04.004Search in Google Scholar
11. Kunz MK, Loftus RJ, Nichols AA. Incidence of uterine tachysystole in women induced with oxytocin. J Obstet Gynecol Neonatal Nurs 2013;42:12–8.10.1111/j.1552-6909.2012.01428.xSearch in Google Scholar
12. Peebles DM, Spencer JA, Edwards AD, Wyatt JS, Reynolds EO, Cope M, et al. Relation between frequency of uterine contractions and human fetal cerebral oxygen saturation studied during labour by near infrared spectroscopy. Br J Obstet Gynaecol 1994;101:44–8.10.1111/j.1471-0528.1994.tb13008.xSearch in Google Scholar
13. Smith S, Zacharias J, Lucas V, Warrick PA, Hamilton EF. Clinical associations with uterine tachysystole. J Matern Fetal Neonatal Med 2014;27:709–13.10.3109/14767058.2013.836484Search in Google Scholar
14. Stewart RD, Bleich AT, Lo JY, Alexander JM, McIntire DD, Leveno KJ. Defining uterine tachysystole: how much is too much? Am J Obstet Gynecol 2012;207:290.e1–6.10.1016/j.ajog.2012.07.032Search in Google Scholar
15. Greiss FC. Uterine and Placental Blood Flow 2009 [Available from: http://editorial.glowm.com/index.html?p=glowm.cml/section_view&articleid=197].10.3843/GLOWM.10197Search in Google Scholar
16. Hadoura E, Selo-Ojeme D. Use of salbutamol by aerosol inhalation in the management of spontaneous uterine hyperstimulation. J Obstet Gynaecol 2005;25:508–9.10.1080/01443610500193072Search in Google Scholar
17. Strasser SM, Kwee A, Visser GH. Spontaneous tachysystole as sign of serious perinatal conditions. J Matern Fetal Neonatal Med 2010;23:736–41.10.3109/14767050903300951Search in Google Scholar
18. Murphy KW, Russell V, Collins A, Johnson P. The prevalence, aetiology and clinical significance of pseudo-sinusoidal fetal heart rate patterns in labour. Br J Obstet Gynaecol 1991;98:1093–101.10.1111/j.1471-0528.1991.tb15360.xSearch in Google Scholar
19. Osterman MJ, Martin JA. Recent declines in induction of labor by gestational age. NCHS Data Brief 2014:1–8.Search in Google Scholar
20. Bor P, Ledertoug S, Boie S, Knoblauch NO, Stornes I. Continuation versus discontinuation of oxytocin infusion during the active phase of labour: a randomised controlled trial. Br J Obstet Gynaecol 2016;123:129–35.10.1111/1471-0528.13589Search in Google Scholar
21. Simpson KR, Knox GE. Oxytocin as a high-alert medication: implications for perinatal patient safety. MCN Am J Matern Child Nurs 2009;34:8–15.10.1097/01.NMC.0000343859.62828.eeSearch in Google Scholar
22. Lee L, Dy J, Azzam H. Management of spontaneous labour at term in healthy women. J Obstet Gynaecol Can 2016;38:843–65.10.1016/j.jogc.2016.04.093Search in Google Scholar
23. Saccone G, Ciardulli A, Baxter JK, Quinones JN, Diven LC, Pinar B, et al. Discontinuing oxytocin infusion in the active phase of labor: a systematic review and meta-analysis. Obstet Gynecol 2017;130:1090–6.10.1097/AOG.0000000000002325Search in Google Scholar
24. Kulier R, Hofmeyr GJ. Tocolytics for suspected intrapartum fetal distress. Cochrane Database Syst Rev 2000:CD000035.10.1002/14651858.CD000035Search in Google Scholar
25. Pullen KM, Riley ET, Waller SA, Taylor L, Caughey AB, Druzin ML, et al. Randomized comparison of intravenous terbutaline vs nitroglycerin for acute intrapartum fetal resuscitation. Am J Obstet Gynecol 2007;197:414.e1–6.10.1016/j.ajog.2007.06.063Search in Google Scholar
26. King TL, Brucker MC, Osborne K, Jevitt C. Varney’s midwifery. 6th ed. Burlington, MA: Jones & Bartlett Learning; 2019. p. 985–7.Search in Google Scholar
27. Perry SE, Hockenberry MJ, Lowdermilk DL, Wilson D, Keenan-Lindsay L, Sams CA. Maternal child nursing care in Canada. 2nd ed. Toronto, ON, Canada: Elsevier Canada; 2017. p. 534–7.Search in Google Scholar
28. Glaser LM, Alvi FA, Milad MP. Trends in malpractice claims for obstetric and gynecologic procedures, 2005 through 2014. Am J Obstet Gynecol 2017;217:340.e1–6.10.1016/j.ajog.2017.05.037Search in Google Scholar
29. Dublin S, Johnson KE, Walker RL, Avalos LA, Andrade SE, Beaton SJ, et al. Trends in elective labor induction for six United States health plans, 2001–2007. J Womens Health (Larchmt) 2014;23:904–11.10.1089/jwh.2014.4779Search in Google Scholar
30. Patterson JA, Roberts CL, Ford JB, Morris JM. Trends and outcomes of induction of labour among nullipara at term. Aust N Z J Obstet Gynaecol 2011;51:510–7.10.1111/j.1479-828X.2011.01339.xSearch in Google Scholar
31. Humphrey T, Tucker JS. Rising rates of obstetric interventions: exploring the determinants of induction of labour. J Public Health (Oxf) 2009;31:88–94.10.1093/pubmed/fdn112Search in Google Scholar
32. Clark SL, Belfort MA, Dildy GA, Meyers JA. Reducing obstetric litigation through alterations in practice patterns. Obstet Gynecol 2008;112:1279–83.10.1097/AOG.0b013e31818da2c7Search in Google Scholar
33. Jonsson M, Norden SL, Hanson U. Analysis of malpractice claims with a focus on oxytocin use in labour. Acta Obstet Gynecol Scand 2007;86:315–9.10.1080/00016340601181318Search in Google Scholar
34. Berglund S, Grunewald C, Pettersson H, Cnattingius S. Severe asphyxia due to delivery-related malpractice in Sweden 1990–2005. Br J Obstet Gynaecol 2008;115:316–23.10.1111/j.1471-0528.2007.01602.xSearch in Google Scholar
35. Wei S, Wo BL, Qi HP, Xu H, Luo ZC, Roy C, et al. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care. Cochrane Database Syst Rev 2013:CD006794.10.1002/14651858.CD006794.pub4Search in Google Scholar
36. Wei SQ, Luo ZC, Qi HP, Xu H, Fraser WD. High-dose vs low-dose oxytocin for labor augmentation: a systematic review. Am J Obstet Gynecol 2010;203:296–304.10.1016/j.ajog.2010.03.007Search in Google Scholar
37. Grunebaum A, Dudenhausen J, Chervenak FA, Skupski D. Reduction of cesarean delivery rates after implementation of a comprehensive patient safety program. J Perinat Med 2013;41:51–5.10.1515/jpm-2012-0181Search in Google Scholar
©2019 Walter de Gruyter GmbH, Berlin/Boston