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Amniotomy and oxytocin treatment of functional dystocia and route of delivery

  • Joseph Seitchik
    Correspondence
    Reprint requests: Dr. Joseph Seitchik, Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284.
    Affiliations
    Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio San Antonio, Texas USA

    the Department of Computer Resources, The University of Texas Health Science Center at San Antonio San Antonio, Texas USA
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  • Alan E.C. Holden
    Affiliations
    Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio San Antonio, Texas USA

    the Department of Computer Resources, The University of Texas Health Science Center at San Antonio San Antonio, Texas USA
    Search for articles by this author
  • Maria Castillo
    Affiliations
    Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio San Antonio, Texas USA

    the Department of Computer Resources, The University of Texas Health Science Center at San Antonio San Antonio, Texas USA
    Search for articles by this author
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      Abstract

      The details of clinical management were examined in 101 nulliparous patients with functional dystocia who underwent amniotomy and were treated with oxytocin in the first stage of labor. It was our hypothesis that if the alleged “high” rate of cesarean sections was the result of mediocre or flawed practices, these should be most evident in patients delivered abdominally. A group of 68 patients delivered vaginally are compared with 33 patients delivered by cesarean section. The means of many variables were statistically similar. The cesarean group was characterized by less cervical dilatation at admission, greater birth weights, larger maximum doses of oxytocin, and longer durations of oxytocin therapy. We conclude from our analysis that the decision to perform cesarean section in nulliparous women with functional dystocia arises from disabilities of the patient and not from differences in the application of our management principles, services, or treatments.

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