Diagnostic criteria and the management of dystocia
Byrd, J.E.; Lytton, D.E.; Vogt, S.C.; Raczek, J.A.
Journal of Family Practice 27(6): 595-599
1988
ISSN/ISBN: 0094-3509 PMID: 3199087 Document Number: 323988
Cephalopelvic disproportion has been identified as making an important contribution to the rising cesarean birth rate. O'Driscoll and colleagues in Dublin, Ireland, have suggested replacement of cephalopelvic disproportion by the term dystocia for failure of labor to progress and have defined two major subcategories: (1) true cephalopelvic disporportion, and (2) inefficient uterine action. A chart audit of reported indications for cesarean birth in a family practice residency population was done, and the patients were classified using the O'Driscoll et al diagnostic criteria for dystocia. When reclassified, the percentage of cesarean births in this population for true cephalopelvic disporportion did not differ significantly from that reported from Dublin (6.1 as compared with 8.8), while the percentage done for inefficient uterine action was significant greater (35.4 as compared with 4.2). This finding suggests there is a set of labors amenable to a management strategy that could result in a decrease in the cesarean birth rates if efficient uterine action is assured with adequate use of oxytocin.