Obstetric outcome in primigravidae with a prolonged deceleration phase

Abstract

SummaryThe late cervimetric progress of 913 consecutive spontaneous primigravid labours has been examined and related to their outcome. A prolonged deceleration phase was present in 44 patients (5 per cent). Of these, only 12 (27 per cent) had a normal vaginal delivery, 17 (39 per cent) had a forceps delivery, and 15 (34 per cent) were delivered by caesarean section. Intravenous oxytocin was administered to 29 patients (66 per cent) with this late first stage abnormality. Of the 16 (55 per cent) who responded by improving their rate of cervical dilatation, 8 (50 per cent) had a normal vaginal delivery and only 2 (13 per cent) had a caesarean section. If there was no improvement, the caesarean section rate was 77 per cent and 6 out of 8 trials of forceps failed. We suggest that prolonged deceleration phase should be treated with oxytocin, but if there is no improvement, any attempt at instrumental delivery should be performed in the operating theatre, with facilities ready for a caesarean section.