Prediction of difficult vaginal birth and of cesarean section for cephalopelvic disproportion in early labor

✍ Scribed by M. Maurice Abitbol; M. Bowen-Ericksen; Ivette Castillo; A. Pushchin

• Book ID: 101292517
• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 64 KB
• Volume: 8
• Category: Article
• ISSN: 1057-0802
• DOI: 10.1002/(sici)1520-6661(199903/04)8:2<51::aid-mfm4>3.0.co;2-w

✦ Synopsis

Objective:

A total of 1,692 patients were evaluated in early labor, and predictions were made for easy labor-vaginal birth, difficult labor-vaginal birth, or improbable vaginal birth-cesarean section.

Methods:

The prediction was based on clinical evaluation of pelvic dimensions, and fetal measurements by sonography at term.

Results:

The combined prediction that a patient would have either a difficult labor-vaginal birth or cesarean section was very accurate (362 out of 370, or 97.8%). however, the separate prediction of difficult labor-vaginal birth and a cesarean section was less accurate, although still significant (73.4% and 90.2%, respectively). a similar study on 141 vaginal birth after cesarean (vbac) candidates showed that by sectioning electively patients in whom cesarean sections were predicted, the cesarean section rate barely increased.

Conclusion:

Careful evaluation of a patient in early labor could help to recognize the dystocic labor-delivery and early indication for cesarean sections. this would avoid unnecessary and prolonged labor without necessarily increasing the cesarean section rate.