Labour dystocia

Definition

• Failure to progress through the stages of labour

Epidemiology

• 8-11% of deliveries have an abnormal first stage of labour

Etiology

• Passenger
  • Abnormal presentation
  • Abnormal position
  • Abnormal fetal development
• Passage
  • Abnormal size or shape of pelvis
• Power
  • Insufficient uterine contractions
  • Insufficient voluntary effort
    • Epidural analgesia
• Other
  • Cephalopelvic disproportion (CPD)
    • Diagnosable only through trial of labour
    • True CPD is rare; much more likely to be abnormal position
  • Failure to progress
    • Must be in active labour

Management

• Walking