Uterine Hyperstimulation





- Uterine hyperstimulation during pregnancy noted by any one of of the following

-  5 or more uterine contractions in 10min over 30min period

-  Contractions lasting >2min

-  Contractions of normal duration occurring within 60sec of each other



- Obstetric emergency

- May occur w or wo fetal heart rage changes on CTG

- Early recognition essential

- Causes poor utero-placental perfusion & decreased fetal oxygenation

-  Fetus requires 60-90sec between each contraction to restore normal oxygen levels



-  Syntocinon infusion

-  Prostin



- Placental abruption



- Ruptured uterus



- Continuous CTG

- Abdo palp: correlate w CTG



- If Cervidil in situ consider removal

- If Prostin in situ consider Terbutaline 250mcg IV or S/C

- Normal CTG

-  Decrease Syntocinon if infusion running

-   Halve rate if uterine activity not reduced by 30min

- Suspicious CTG

-  Decrease Syntocinon if infusion running

-   If CTG improves after 30min can continue w caution

-   If CTG does not improve cease infusion

-  Postion to left lateral

-  IV fluids

- Abnormal CTG

-  Cease Syntocinon infusion

-  VE to assess progress

-  Exclude placental abruption

-  Left lateral position

-  IV fluids

-  +/- scalp lactate

-  If Hypersimulation persists

-   Terbutaline 250mcg IV or S/C

-  +/- Expediated birth if CTG does not improve or scalp lactate >4.7mol/L






Uterine Hyperstimulation: Fetal Management Guidelne, Southern Health, August 2009