Cervical dystocia versus uterine inertia

1. 1. Fifty-nine cases of cervical dystocia are presented by combination and analysis of the data. 2. 2. Three cases followed cervical cauterization, five followed previous surgery on the cervix, and one followed a known previous laceration. It is possible that even untreated chronic cervicitis may cause sufficient fibrosis to impede normal dilation during labor. 3. 3. Forty-three patients were delivered by cesarean section and sixteen vaginally. Six sections were done without labor, three following failure of induction attempts. 4. 4. There were fifty-five cephalic presentations and four breech. Varying degrees of cephalopelvic disproportion were present in eleven cases. There were eighteen occipitoposterior positions and one mentoposterior. The fetal weights were about average, the section babies weighing an average of 10 ounces more than the vaginally delivered babies. 5. 5. The average length of labor of the patients delivered by cesarean section and those delivered per vaginam were about the same. With a little more patience in some of the cases of the former group, vaginal delivery could probably have been successfully accomplished. 6. 6. Twenty-five patients were noted to have uterine inertia. It is suggested that in some of these cases this was the principal factor rather than cervical dystocia in the prolongation of labor, and with further attention to the inertia, there might have been more successful vaginal deliveries. Failure of good labor to develop from an induction attempt does not mean that the patient will never go into labor or that the cervix will not dilate properly.