Tachysystolie

Tachysystolie, or tachysystole, is an obstetric term describing excessively frequent uterine contractions during labor. It is usually defined as more than five contractions in a 10-minute period, averaged over a 30-minute window, with contractions occurring at short intervals. This condition can be present with or without fetal heart rate abnormalities.

The most common cause is stimulation of the uterus with uterotonic medications used to induce or augment labor, such as oxytocin or prostaglandins. Less commonly, tachysystole may occur due to mismanagement of labor, uterine hyperstimulation syndromes, uterine overdistension, infection, or placental factors.

Clinically, tachysystole is detected through continuous fetal and maternal monitoring. It may be associated with non-reassuring fetal heart rate patterns, such as late or variable decelerations, suggesting reduced placental perfusion. It can increase the risk of fetal hypoxia and acidosis if not managed promptly.

Management focuses on reducing driving factors and protecting fetal well-being. The primary step is to reduce or discontinue uterotonic agents; patient positioning (often left lateral), ensuring adequate hydration, and maternal oxygen administration may be used. If contractions remain excessive, a tocolytic agent such as terbutaline or calcium-channel blockers may be employed, depending on clinical context. Persistent tachysystole with fetal distress may necessitate expedited delivery, guided by obstetric assessment and patient factors.