This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'All are true regarding dystocia except: \nSelect and explain. \nA. Dystocia is difficult labor, B. It is the M/C indication for primary cesarean delivery, C. ACOG recommends the cervix should be atleast 2 cms dilated for diagnosis of dystocia, D. Dystocia can be due to abnormality in power, passage and passenger', 'role': 'user'}, {'content': 'Answer: C \nExplanation: Dystocia literally means difficult labor and is characterized by abnormally slow labor progress.\nIt arises from four distinct abnormalities that may exist singly or in combination:\n\n– Abnormalities of the expulsive forces. Uterine contractions maybe insufficiently strong or inappropriately coordinated to efface and dilate the cervix–uterine dysfunction. Also, there may be inadequate voluntary maternal muscle effort during second-stage labor.\n– Abnormalities of presentation, position, or development of the fetus.\n– Abnormalities of the maternal bony pelvis–that is, pelvic contraction.\n– Abnormalities of soft tissues of the reproductive tract that form an obstacle to fetal descent.\nCommon clinical findings in women with ineffective labor\nInadequate cervical dilation or fetal descent:\n\nProtracted labor–slow progress\nArrested labor–no progress\nInadequate expulsive effort–ineffective pushing.\nFetopelvic disproportion:\nExcessive fetal size\nInadequate pelvic capacity\n\nMalpresentation or position of the fetus\n\nRuptured membranes without labor.\nDystocia is the most common current indication for primary cesarean delivery.\nAmerican College of Obstetricians and Gynaecology recommend (1995a) that the cervix be dilated to 4 cm or more before dystocia is diagnosed, thus, the diagnosis often is made before active labor, and therefore before an adequate trial of labor which leads to unnecessary cesarean section.', 'role': 'assistant'}]