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Progesterone Concentrations in Maternal and Fetal Serum Are Lower During Functional Dystocia Than in Normal Labor

From the Departments of Obstetrics and Gynecology and Physiology, University of Umea, UmeA; and the Department of Obstetrics and Gynecology, Academic Hospital, Uppsala, Sweden

Abstract

Concentrations of progesterone and estradiol (E₂) were measured in parturient serum and in fetal cord serum during normal labor and in women with functional dystocia. In the study group, there were no cases of cephalopelvic disproportion. In oxytocin-resistant dystocia, the course of labor could not be corrected with oxytocin. To ascertain the effect of oxytocin, we included a number of women whose labor had been induced with oxytocin, followed by normal cervical dilatation and descent of the fetus. All the parturients were grouped retrospectively into those with normal labor and those with dystocia, based on previous definitions. The serum concentrations of progesterone in both the fetal cord and maternal vein were found to be significantly lower in the oxytocin-resistant dystocia group than in women in spontaneous normal labor and those with oxytocin-induced labor and normal progression (P < .05-.005). Oxytocin had no evident effect on the serum concentration of either progesterone or E₂, nor did concentrations vary following epidural blockade. Serum E₂ concentrations in the maternal vein were similar in all delivery groups. Fetal cord E₂ serum concentrations were similar in all vaginal deliveries. Women with the most severe oxytocin-resistant dystocia, delivered by cesarean, had significantly lower serum concentrations of E₂ in fetal cord serum compared with the vaginally delivered women (P < .001).