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Williams Obstetrics, 23e
| Section IV. Labor and Delivery > |
Chapter 20. Abnormal Labor
Sections: Abnormal Labor: Introduction, Overview of Dystocia, Abnormalities of the Expulsive Forces, Ruptured Membranes without Labor, Precipitous Labor and Delivery, Fetopelvic Disproportion, Shoulder Dystocia, Maternal and Fetal Complications with Dystocia, References.
Topics Discussed: dystocia.
Excerpt:"In 2007, the cesarean delivery rate was 31.8 percent—the highest level ever reported for the United States (Hamilton and co-workers, 2009). According to the American College of Obstetricians and Gynecologists (2003), approximately 60 percent of primary cesarean deliveries in the United States are attributable to the diagnosis of dystocia. Roy (2003) has proposed that this high frequency results from environmental changes that are developing more rapidly than Darwinian natural selection. Humans are poorly adapted to the affluence of the modern diet, and one result is dystocia. Evidence in support of this comes from Barau and associates (2006), who analyzed prepregnancy body mass index (BMI) and the risk of cesarean delivery. They studied 16,592 singleton births and reported a linear association between BMI and cesarean delivery. This has been similarly shown by others (Leung, 2008; Nuthalapaty, 2004; Roman, 2008; Treacy, 2006; Wilkes, 2003, and all their colleagues). As further discussed in Chapter 43, Getahun and co-workers (2007) reported that obesity is associated with an increased cesarean delivery rate. Interestingly, these researchers found that a decrease in weight from obese to normal eliminates this risk...."
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