Prediction of caesarean section for labor dystocia in women with full-term single pregnancy with head presentation of the fetus

Abstract

The actual problems of modern obstetrics are the labor management and a decrease of emergency caesarean section’s frequency. The aim of the study was to optimize the definition of indications for abdominal delivery by determining risk factors and forecasting on the basis of clinical and anamnestic indicators. A retrospective clinical and statistical analysis of pregnancy and childbirth histories of 484 mothers – 65 women in which labor was complicated by labor dystocia (LD) and caesarean section (CS) and 419 women after vaginal labor was performed. Three factors had the greatest dependency with CS for LD: burdened gynecological anamnesis (OR – 21.134; 95% CI 6.501-68.708); diabetes mellitus (OR – 19.462; 95% CI 5.018-75.485) and fetal-pelvic disproportions (OR – 11.556; 95% CI 2.692-49.595). Genital tract infections, primiparous and cardiovascular diseases had OR more than 5.0. OR was greater than 3.0 in hypertension, preeclampsia, premature rupture of amniotic membranes, and late reproductive age. Conclusions. The greatest influence on the likelihood of CS for LD is observed in premature rupture of amniotic membranes, diabetes mellitus, burdened gynecological history and cardiovascular diseases in the primiparous of late reproductive age.

Keywords

• abor dystocia
• caesarean section
• risk factors
• odds ratio
• predicting