The American literary institution [...

The American literary institution [i]or[/i] seminary of learning of Obstetricians and Gynecologists has released a practice bulletin onward dystocia and augmentation of labor. "ACOG Practice Bulletin Number 49: Dystocia and Augmentation of Labor" appears in the December 2003 issue of Obstetrics and Gynecology and is available online at http://www.greenjournal.org/cgi/reprint/102/6/1445.

Dystocia, characterized by dint of the slow, abnormal progression of labor, is the leading indication for primary cesarean delivery in the United States. single in kind out of every 10 women who give birth in the United States has had a previous cesarean delivery. Because many repeat cesarean deliveries are performed after primary operations for dystocia, an estimated 60 percent of all cesarean deliveries in the United States are attributable to dystocia. With decreasing rates of vaginal birth after cesarean delivery, dystocia is the leading cause of the two operative vaginal delivery and cesarean delivery and their accompanying complications.

Despite the high prevalence of labor disorders, considerable variability exists in the diagnosis, management, and criteria for dystocia that requires intervention.

Among the recommendations are the following:

* Patients should be admonitioned that walking during labor does not enhance or improve progres in labor, nor is it harmful.

* Continuous support during labor from caregivers should be encouraged because it is beneficial for women and their newborns.

* Active management of labor may shorten labor in nulliparous women although it has not consistently been shown to change into the rate of cesarean delivery.

* Amniotomy may be used to enhance progres in active labor if it be not that may increase the risk of maternal fever

* Radiographic pelvimetry alone as a predictor of dystocia has not been shown to have benefit and, therefore, is not recommended

* Intrauterine constraining force catheters may be helpful for women when the evaluation of contractions is difficult because of as it is factors as obesity.

* Women with twin gestations may endure augmentation of labor.

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group