Learn all about uterine tetany meaning, causes, symptoms and treatment. Uterine tetany is a rare, but serious childbirth complication that can occur during vaginal birth. It causes a mother’s uterus to tear so her baby slips into her abdomen. This can cause severe bleeding in the mother and can suffocate the baby.
This condition affects less than 1 percent of pregnant women. It almost always occurs in women with uterine scars from previous cesarean deliveries or other uterine surgeries. A woman’s risk of uterine tetany increases with every cesarean section. Side effects of tetanus immunization occur in approximately 25% of vaccine recipients. The most frequent side effects are usually quite mild (and familiar) and include soreness, swelling, and/or redness at the site of the injection. More significant reactions are extraordinarily rare. The incidence of this particular reaction increases with decreasing interval between boosters.
Uterine tetanus a potentially life-threatening condition for both mother and infant, occurs in <0.1% of all pregnant women and <1% of women attempting vaginal birth after cesarean section (VBAC). Dramatic increases in uterine blood flow (60 to 600 mL/min) may result in rapid exsanguination if there is avulsion of the uterine vessels or rupture of the uterus. The occurrence of couvelaire uterus can be prevented by prevention of abruptio placentae. This include proper management of hypertensive states of pregnancy; treatment of maternal diseases like diabetes mellitus, and other collagen disease complicating pregnancy; prevention of trauma during pregnancy; mothers should also avoid smoking or consumption of alcohol during pregnancy.
There are some drugs that prevent preterm labor and immature birth by suppressing uterine contractions (TOCOLYSIS). Agents used to delay premature uterine activity include magnesium sulfate, beta-mimetics, oxytocin antagonists, calcium channel inhibitors, and adrenergic beta-receptor agonists. The use of intravenous alcohol as a tocolytic is now obsolete. The toxin already circulating in the body is neutralized with antitoxin drugs. The tetanus toxin causes no permanent damage to the nervous system after the patient recovers.
After recovery, patients still require active immunization because having the tetanus disease does not provide natural immunization against a repeat episode.
What is Uterine Tetany?
Uterine tetany in pregnancy is a rare and often catastrophic complication with a high incidence of fetal and maternal morbidity. Numerous factors are known to increase the risk of uterine rupture, but even in high-risk subgroups, the overall incidence of uterine tetanus is low. The estimated incidence is ~1% of all pregnancies. The rate of placental abruption is thought to have dramatically increased in the past few years.
Uterine Tetany Meaning
Uterine tetany is a condition characterized by uterine contractions that are extremely prolonged. This condition may be life threatening to the fetus.
Uterine Tetany Causes
Uterine tetany could result from the use of oxytocin to induce labor. Because oxytocin promotes powerful uterine contractions and then uterine tetany may occur. The oxytocin infusion must be stopped to prevent uterine rupture and fetal compromise. The exact etiology is unknown, but the final pathophysiology is likely to rupture of a spiral artery with hemorrhage into the decidua basalis leading to separation of the placenta. The small vessel disease seen in abruption placentae may also result in placental infarction.
Uterine Tetany Symptoms
The initial signs and symptoms of uterine rupture are typically nonspecific, which makes the diagnosis difficult and sometimes delays definitive therapy. From the time of diagnosis to delivery, generally only 10-37 minutes are available before clinically significant fetal morbidity becomes inevitable. A variety of symptoms are associated with uterine ruptures. Some possible symptoms include:
- excessive vaginal bleeding
- sudden pain between contractions
- contractions that become slower or less intense
- abnormal abdominal pain or soreness
- recession of the baby’s head into the birth canal
- bulging under the pubic bone
- sudden pain at the site of a previous uterine scar
- loss of uterine muscle tone
- rapid heart rate, low blood pressure, and shock in the mother
- abnormal heart rate in the baby
- failure of labor to progress naturally
Uterine Tetany Treatment
Uterine tetany treatment is done by medications which defend against tetanus. The uterus should be evacuated and contractions should be stimulated using intravenous oxytocin; hysterectomy (the removal of the uterus) may be needed in some cases. Antibiotics (usually metronidazole) are given intravenously to kill the bacteria and thus stop the production of toxin. However, antibiotics have no effect on toxin that has already been produced. Such toxin continues to cause muscle spasms. A single dose of tetanus immune globulin is usually injected into a muscle to neutralize the toxin already produced. If tetanus immune globulin is unavailable, doctors may give people nonspecific immune globulin, which contains many different antibodies, including those that defend against tetanus.