Hypertonic dysfunctional labour is generally characterized by:

Types of Uterine Dysfunction There are two types of uterine dysfunction: In the more common hypotonic uterine dysfunction, there is o basal hypertonus and uterine cotractions have a normal gradient pattern (synchronous), but the slight rise in pressure during a contraction is insufficient to dilate the cervix. In the other, hypertonic uterine dysfuctio or incoordinate uterine dysfunction, either the basal tone is elevated appreciably or the pressure gradient is distorted. Gradient distortion may result from contraction of the mid-segment of the uterus with more force than the fundus or from complete asynchronism of the impulses originating in each cornu, or from a combination of these two. Pain is present before, during and after contractions. This results in fetal hypoxia in labor. Placental abruption is often associated with high baseline tone (> 25 mm Hg). On CTG the FHR shows reduced variability and late decelerations. Effect on the fetus: Fetal distress appears early due to placental insufficiency caused by inadequate relaxation of the uterus. Management: There is no place of oxytocin augmentation with this abnormality. Cesarean section is done in majority of cases. Adequate pain relief or sedation is helpful.