A primigravida at 40 weeks of gestation is having uterine contractions every 1 1/2 to 2 minutes and says that they are very painful.Her cervix is dilated 2 cm and has not changed in 3 hours.The woman is crying and wants an epidural.What is the likely status of this woman's labor?

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Women who experience hypertonic uterine dysfunction,or primary dysfunctional labor,often are anxious first-time mothers who are having painful and frequent contractions that are ineffective at causing cervical dilation or effacement to progress.With hypotonic uterine dysfunction,the woman initially makes normal progress into the active stage of labor and then the contractions become weak and inefficient or stop altogether.The contraction pattern seen in this woman signifies hypertonic uterine activity.Typically uterine activity in this phase occurs at 4- to 5-minute intervals lasting 30 to 45 seconds.Pelvic dystocia can occur whenever contractures of the pelvic diameters reduce the capacity of the bony pelvis,including the inlet,midpelvis,outlet,or any combination of these planes.

A Primigravida at 40 Weeks of Gestation Is Having Uterine