You are caring for a primiparous woman admitted to labor and delivery for induction of labor at 42 weeks' gestation. She asks you to explain the factors that contribute to prolonged labor. The best response would be to state the following:
a. Primiparous women are not at risk for dystocia because they usually have small babies.
b. Dystocia is related to uterine contractions, the pelvis, the fetus, the position of the mother, and psychosocial response.
c. Labor is primarily associated with pelvic abnormalities.
d. Dystocia is typically diagnosed prior to labor based on pelvimetry.
ANS: b
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a. Dystocia is not exclusively related to fetal size and being primiparous.
b. This is the only correct definition of prolonged labor and dystocia. The success of any labor depends on the complex interrelationship of several factors: fetal size, presentation, position, size and shape of the pelvis, and quality of uterine contractions.
c. Pelvic abnormality is the least important contributor to dystocia.
d. Dystocia is diagnosed during, not prior to, labor.
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