Cephalopelvic disproportion is associated with an altered uterine contraction shape in the active phase of labor

American Journal of Obstetrics and Gynecology
Janyne E AlthausKarin J Blakemore


The purpose of this study was to determine if intrapartum contractions of a particular shape (rapid rise with slower return to baseline) are predictive of cephalopelvic disproportion (CPD). In an institutional review board (IRB)-approved study, cohorts of 100 women who underwent spontaneous vaginal delivery (SVD) and 100 who underwent cesarean section (C/S) for CPD or arrest of labor were consecutively identified between January 2004 and March 2005. Inclusion criteria included term, singleton pregnancies, nulliparity, and absence of fetal anomalies. One hour of interpretable electronic fetal monitoring (EFM) was obtained in active labor. Fall to rise (F:R) ratio was calculated by measuring the time for a contraction to return to its baseline from its peak ("fall") and the time for a contraction to rise to its peak ("rise"). The F:Rs were then averaged over the number of contractions. Data were analyzed using Student t test, Chi-square, and Fisher exact tests where appropriate. Maternal demographics are listed in Table I. The average F:R ratio was 1.55 for SVD versus 1.77 for C/S, a statistically significant difference (P = .00003). Analysis of variance revealed this difference persists when controlled for the potentially confou...Continue Reading


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Related Concepts

Labor Onset
Uterine Contraction
Nested Case-Control Studies
Cephalopelvic Disproportion

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