Does coupling of uterine contractions reflect uterine dysfunction?

In a cohort analytical study 47 primigravidas in spontaneous normal labour at term were divided into two groups depending on the presence or absence of coupled uterine contractions during active labour. During monitoring with a pressure-tip intra-uterine catheter, 24 patients developed coupled contractions and 23 had a normal contraction pattern. There were no statistically significant differences between the two groups with regard to maternal age, gestational age, maternal height, fetal weight, head circumference and pelvic size. Patients who developed coupled contractions had a longer duration of labour, a higher uterine activity integral and an increased incidence of caesarean section for failure to progress. Because coupling of uterine contractions may be indicative of dysfunctional uterine activity, and hence a prolonged first stage of labour, failure to progress during labour in these patients should be interpreted with caution in order to avoid the incorrect diagnosis of cephalopelvic disproportion.