Dystocia: a study of its frequency and risk factors in seven cities of west Africa

• Published in: International journal of gynecology and obstetrics Vol. 74; no. 2; pp. 171 - 178
• Main Authors: Ould El Joud, D., Bouvier-Colle, M.-H.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.08.2001; Elsevier Science
• Subjects: Africa; Africa, Western; Biological and medical sciences; Cephalopelvic disproportion; Cohort Studies; Delivery. Postpartum. Lactation; Disorders; Dystocia; Dystocia - epidemiology; Female; Gynecology. Andrology. Obstetrics; Humans; Incidence; Medical sciences; Obstructed labor; Pregnancy; Prenatal Care; Prolonged labor; Prospective Studies; Risk Assessment; Risk Factors; Screening; Tropical medicine; West Africa; Africa; Africa, Western; Screening; Dystocia; Cephalopelvic disproportion; Africa; Obstructed labor; Risk factors; Prolonged labor; Human; Statistical analysis; Pregnancy disorders; Risk analysis; Medical screening; Incidence; Prospective; Prenatal; Prevention; Consultation; Risk factor; Delivery disorders; Female
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/S0020-7292(01)00407-6

Objectives: To determine the incidence of dystocia in seven west African cities, to attempt to discover what, if any, factors at the prenatal visit might identify women at risk of dystocia, and to assess the utility of such screening. Method: This prospective population study of 20 326 pregnant women in west Africa (MOMA) analyzed risk factors for dystocia on the basis of deliveries in health care facilities. Results: Incidence of dystocia was 18.3%. In the multivariate analysis, the risk factors were small stature, previous cesarean, and nulliparity. As screening tools these factors have inadequate positive predictive values, either singly or combined. Conclusion: It is almost impossible to predict the occurrence of dystocia before the onset of labor. Therefore, labor must be carefully monitored, and there must be health care facilities available that can manage complications, especially cesarean deliveries. If such facilities are not accessible, an effective referral system must be established.