Faults in the birth canal

Cephalopelvic disproportion

• this is a clear indication in cases of gross pelvic contraction
• it is borderline cases where good judgement is required
• if a trial labour, with some hours of cautious oxytocic augmentation of uterine contraction, does not result in cervical dilatation then one should proceed to section without delay

Pelvic tumour

• impaction of an ovarian cyst or fibroid in the pelvis is a rare indication for section

Cervical or Vaginal stenosis

Double uterus

• the non-impregnated horn may lie below the presenting part of the foetus