Difficult labor, abnormally difficult childbirth: Dystokia may be caused by either the size of the the baby or the small size of the pelvic outlet.

A large size of the baby can cause this condition. Other factors are malpositions of the baby (transverse, face, brow, breech, or compound presentation), abnormalities of the baby (hydrocephalus, tumors of the neck or abdomen, hydrops), and multiple pregnancy with interlocked twins.

Dystokia generally can be detected by vaginal examination, ultrasound, and external pelvimetry before the patient goes into labor.