INTRAPARTUM PREDICTION OF FETAL STATUS AND ASSESSMENT OF LABOR PROGRESS

The application of standardized clinical definitions of dystocia by peer review have resulted in reduced caesarean rates with unchanged or reduced perinatal mortality. This model is the basis of a different method of standardizing the diagnosis of arrest of cervical dilatation. The diagnosis is accomplished using a mathematical model of labour which has been derived from original data, and is applied dynamically so that the predicted values are adjusted as the forces which promote or impede labour change. The simulations indicate that clinical performance could be improved while maintaining a high degree of sensitivity for cases which meet standard clinical definitions of arrest of dilatation. This simulation has produced encouraging results suggesting that its use could reduce substantially the overall rate of caesarean for arrest of dilatation from 5.3% to 3.1%. © 1994 Billière Tindall All rights reserved.