Dystocia, characterized by the slow, abnormal progression of labor, is the leading indication for primary cesarean delivery in the United States. Currently, 1 in every 10 women who give birth in the United States has had a previous cesarean delivery (1). Because many repeat cesarean deliveries are performed after primary operations for dystocia, an estimated 60% of all cesarean deliveries in the United States are attributable to the diagnosis of dystocia (2). Thus, with decreasing rates of vaginal birth after cesarean delivery, dystocia is the leading cause of both 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. The purpose of this document is to provide a review of the definition of dystocia, risk factors associated with dystocia, the criteria that require delivery, and approaches to clinical management of labor complicated by dystocia.
(C) 2003 by The American College of Obstetricians and Gynecologists.