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Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting
Lotta Selin1, Gunnar Wallin, Marie Berg
1Department of Obstetrics and Gynecology, NU Hospital Group, Trollhättan, 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.
