Computer diagnosis of labor progression.

Abnormal labor has been suspected of being inherently delectorious to the fetus. In order to explore this problem, clinical factors, labor progress, and fetal monitoring parameters were compared in matched groups of high-risk patients whose fetuses were in theoccipitoposterior (0P) and occipitoanterior postions. The OP group showed significant excesses of dysfunctional labor aptterns, uterine contraction pattern abnormalities, and late and variabl fetal heart rate decelerations not accounted for by theuse of oxytocin or the presence of cord problems. In OP labor, lower Apgar scores were associated withasignificant excess of preceding fetal heart rate decelerations independant of operative delivery. This study suggests that neonatal depression in OP laboris related to intrapartum factors preceding delivery and provides direct support for theconcept that abnormal labor may adversely affect the fetus. The OP position is an indication for close fetomaternal supervision during labor.