Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting

Background. Labour dystocia (LD) is associated with adverse maternal and child outcomes. This study investigated obstetric risk factors, frequency of interventions and delivery outcomes for LD. Methods. A retrospective, observational, study of 1,480 deliveries was undertaken in a Swedish district hospital during 2000 and 2001. Results. LD was identified in 21% of deliveries, 16.7% of which ended in caesarean section (CS) compared to 1.7% of deliveries without LD. Multiparity with no previous vaginal delivery (OR=6.0), epidural analgesia (EDA) at cervical dilation <= 5 cm (OR=4.6), primiparity (OR=4.5), gestational age >= 42 weeks (OR=3.1), birth weight > 4,000 g (OR=2.7) and EDA at cervical dilation > 5 cm (OR=2.0) were major independent risk factors for LD. Conclusions. In delivery management, special attention should be directed to primiparous women and multiparous women with no previous vaginal delivery. Women given EDA, especially at cervical dilation >= 5 cm are also of particular interest. Furthermore, rigorous routines for LD diagnosis and oxytocin augmentation are important.