Intrauterine‐pressure studies in African nulliparae: delay, delivery and disproportion

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Abstract
Uterine activity was measured in 43 African nulliparae who were in the active phase of spontaneous labor and in whom delay in cervical dilation had occurred. Details of labor were recorded on a partogram, on which an alert and an action line were drawn, and which were 2 h apart. Delay was defined as a cervical dilatation rate of < 1 cm/h. Uterine activity was measured with a fluid-filled intrauterine catheter, an external strain gauge and a pressure-curve integrator. The uterine activity levels which were observed in association with delay are considerably less than those associated with normal labor progress. The uterine activity levels that were associated with pitocin augmentation after the action line and which resulted in vaginal delivery were analyzed. They were similar to the levels observed in normal labor. The uterine activity levels which were associated with failure to progress in labor beyond the action line were also analyzed. It is argued that a minimum uterine activity level of 1800 kPas[kilopascals]/15 min is required to fully test the cephalopelvic relation.

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