Kjaergaard et al identified risk factors for dystocia (abnormal labor or childbirth) in nulliparous women. These can help to identify a woman who may require more aggressive management. The authors are from Copenhagen University Hospital, University of California Los Angeles and Lund University (Sweden).


Risk factors for dystocia seen on admission of a nulliparous woman in labor:

(1) The cervical dilatation is < 4.0 cm.

(2) The cervix has a dense consistency.

(3) The wall of the lower uterine segment is thick.

(4) The fetal head is above the interspinal plane.

(5) There is poor contact between the fetal head and the cervix.


Additional risk factor:

(6) Administration of epidural analgesia.


The risk for dystocia increases with the number of risk factors present.


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