Dystocia

 

 

 

Acta Obstet Gynecol Scand. 2008;87(2):216-21.

Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting.
Selin L, Wallin G, Berg M.

Department of Obstetrics and Gynecology, NU Hospital Group, Trollh?tan, Sweden. lotta.selin@vgregion.se

Background:

Labour dystocia (LD) is associated with adverse maternal and child outcomes. This study investigated obstetric risk factors, frequency of interventions and delivery outcomes for LD.

Methods:

A retrospective, observational, study of 1,480 deliveries was undertaken in a Swedish district hospital during 2000 and 2001.

Results:

LD was identified in 21% of deliveries, 16.7% of which ended in caesarean section (CS) compared to 1.7% of deliveries without LD. Multiparity with no previous vaginal delivery (OR=6.0), epidural analgesia (EDA) at cervical dilation < or =5 cm (OR=4.6), primiparity (OR=4.5), gestational age > or =42 weeks (OR=3.1), birth weight >4,000 g (OR=2.7) and EDA at cervical dilation >5 cm (OR=2.0) were major independent risk factors for LD.

Conclusions:

In delivery management, special attention should be directed to primiparous women and multiparous women with no previous vaginal delivery. Women given EDA, especially at cervical dilation < or =5 cm are also of particular interest. Furthermore, rigorous routines for LD diagnosis and oxytocin augmentation are important.