Prolonged labor.

Dystocia is usually the result of inadequate uterine contraction or slow cervical dilation or both. Some conditions causing these deficiencies are large size of the infant, multiple pregnancy, hydramnios, faulty presentation (particularly the occiput-posterior), occluding tumors, fullness of the bladder, umbilical cord impediment, concealed uterine hemorrhage, clamping of a thick anterior cervical lip by the infant's head, adhesion of the membranes to the cervix, or delay in rupture of the membranes. Dystocia is often observed in patients with hypopituitarism. A nervous, worrying temperament may seriously affect the progress of labor. Maneuvers that are helpful in many of these difficulties are described and the indications and dosages for Pitocin(R) are presented.