Abstract
Objective: A total of 1,692 patients were evaluated in early labor, and predictions were made for easy labor-vaginal birth, difficult labor-vaginal birth, or improbable vaginal birth-cesarean section.Methods: The prediction was based on clinical evaluation of pelvic dimensions, and fetal measurements by sonography at term.Results: The combined prediction that a patient would have either a difficult labor-vaginal birth or cesarean section was very accurate (362 out of 370, or 97.8%). However, the separate prediction of difficult labor-vaginal birth and a cesarean section was less accurate, although still significant (73.4% and 90.2%, respectively). A similar study on 141 vaginal birth after cesarean (VBAC) candidates showed that by sectioning electively patients in whom cesarean sections were predicted, the cesarean section rate barely increased.Conclusion: Careful evaluation of a patient in early labor could help to recognize the dystocic labor-delivery and early indication for cesarean sections. This would avoid unnecessary and prolonged labor without necessarily increasing the cesarean section rate.
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