Symphysis-fundus height, maternal height, labor pattern, and mode of delivery

Fetal growth was monitored with use of symphysis-fundus charts in 920 consecutive term singleton pregnancies with cephalic presentation. There were 402 primigravid and 518 multigravid patients. The symphysis-fundus charts were divided into four zones and the patients allocated into groups according to the zone of the last symphysis-fundus height measurement before the onset of labor. A highly significant increase was noted in the incidence of abnormal labor and operative delivery in group A primigravid women (symphysis-fundus height above the ninetieth centile), which was even more pronounced when the effect of epidural analgesia was excluded. Conversely, there was a significant progressive increase in the proportion of operative deliveries for fetal distress from group A through group D (symphysis-fundus height below the tenth centile). Similar trends were significant but less pronounced among multigravid women. The relationship between maternal height, symphysis-fundus height, and operative delivery for dystocia in primigravid women was examined. High operative delivery rates were present in group A primigravid patients regardless of maternal height. In groups B and C, however, increased maternal height was associated with lower operative delivery rates.