Document Detail


Station of the fetal presenting part. VI. Arrest of descent in nulliparas.
MedLine Citation:
PMID:  1250535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The specific labor aberration of arrest of descent was investigated in 253 nulliparas. It was found to be associated with fetopelvic disproportion in 52%. Delivery outcome was adversely affected by such factors as high fetal station at time of arrest and long duration of arrest. Arrest of descent occurring during the administration of oxytocin infusion was particularly ominous, no patient subsequently delivering vaginally. The best delivery prognosis was seen in those cases in which apparently causative inhibitory agents, including peridural anesthesia and sedation, were allowed to abate expectantly. Neither immediate operative delivery nor expectancy (other than in the specific abatement cases) was determined to be an appropriate approach to resolving this problem. Postarrest progression, especially if at a rate that was the same as or greater than prearrest descent, proved to be a favorable sign for delivery outcome. Neonatal depression and birth trauma were closely correlated with midforceps procedures, especially when done in conjunction with forceps rotation. Cephalopelvic disproportion yielded poor perinatal results, particularly among those delivered vaginally by instrumental means. Uterotonic stimulation of labor to correct the arrest problem therapeutically also had an adverse effect on the fetus when followed by operative delivery. Based on these observations a program of management was evolved for treating patients with arrest of descent.
Authors:
E A Friedman; M R Sachtleben
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  47     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1976 Feb 
Date Detail:
Created Date:  1976-04-15     Completed Date:  1976-04-15     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  129-36     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Obstetrical / adverse effects
Delivery, Obstetric / methods
Dilatation
Female
Humans
Labor Presentation*
Labor Stage, First
Labor Stage, Second
Obstetric Labor Complications* / etiology,  therapy
Parity
Pregnancy
Prognosis
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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