Medical management of arrest disorders of labor: a current overview

In order to evaluate the risks specifically related to arrest disorders of labor, obstetric management and perinatal outcome were studied in 5399 births selected to exclude risks clearly not caused by abnormal labor. Management was primarily medical--among patients with arrest disorders, the cesarean rate was 13% and the midforceps rate was 4%, and among those having cesarean or midforceps delivery, 96% received prior oxytocin stimulation. Perinatal outcome was assessed by the parameters of mortality, low Apgar scores, admission to the nursery intensive care unit, and neurological abnormality. With medical management, arrest disorders were not associated with an increased risk of the adverse perinatal outcome evaluated in this study. It appears possible to reduce operative rates for arrest disorders of labor safely by more extensive use of medical management.