North American Registry of Midwives (NARM) Practice Exam

What best describes hypotonic uterine dysfunction?

1. Painful contractions with cervical dilation

2. Normal gradient pattern with poor tone

3. Normal uterine tone but irregular patterns

4. Excessively strong contractions

The correct answer is: Normal gradient pattern with poor tone

Hypotonic uterine dysfunction is characterized by a situation where the uterine contractions are present but weak and insufficient to effectively promote cervical dilation and progress labor. The term "hypotonic" implies a lack of tone or insufficient strength in the contractions. In this context, the phrase "normal gradient pattern with poor tone" accurately depicts hypotonic uterine dysfunction. This indicates that while there may be some contractions occurring, they are not strong enough to lead to effective labor progress. It reflects a scenario where the uterus is capable of contracting (indicating a gradient of contractions) but lacks the necessary force (poor tone) to facilitate labor. In contrast, the other options depict different types of uterine activity. Painful contractions with cervical dilation would suggest effective, strong contractions, which is not consistent with hypotonic dysfunction. Normal uterine tone but irregular patterns points to an issue with the timing and regularity of contractions rather than their strength. Excessively strong contractions would signify hypertonic dysfunction, where contractions are too strong and can potentially lead to complications. Understanding these distinctions allows for better identification and management of different labor patterns.