Labor graph (dystocia)


From: BirthSource.com: (http://www.birthsource.com/scripts/article.asp?articleid=120). Protracted disorders refer to a series of events including protracted active phase dilation (slower than normal rate of cervical dilation) and protracted descent (delayed descent of the fetal head in the active phase). A laboring woman, who has a slower than normal rate of cervical dilation, is said to have a protraction disorder. Diagnostic criteria are 1.2 cm per hour for primips and 1.5 cm per hour for multips. For protracted descent, the criteria are less than 1.0 cm per hour in primips and less than 2.0 cm per hour for multips. A slow progress may be the result of CPD (cephalopelvic disproportion). Most women, however, benefit greatly from adequate hydration and some nutrition, emotional reassurance, position changes ~ these women may go on and deliver vaginally. Arrest disorders include secondary arrest of dilation (no progress in cervical dilation in more than 2 hours), arrest of descent (fetal head does not descend for more than 1 hour in primip and more than 0.5 hours in multip), and failure of descent (no descent). Much of the diagnostic reference for protracted disorders is associated with the Friedman Labor Curve. For the past half-century obstetric practice has followed the description of normal labor set out in a landmark, 500 person study by Dr. Emanuel Friedman. Friedman established the following definitions of labor progression in 1955: * Protracted active labor: less than 1.2 cm/hr. * Active phase at rest: no dilation for 2 hours. * Protracted descent: less than 1 cm/hr. * Arrested descent: no descent for 1 hour. Notes form Jeanette Koshar: The above labor graph is an average. Note the black line is the mean. As with any data, "average" also takes in the 2 standard deviations on either side of the mean. Hence the latent phase average is 6-8 hours, active is 3-6 and transition is 20-40 minutes. The above information is meant to be used as a guide. Look at the whole picture!! How well are the mother and fetus doing?

From: BirthSource.com: (http://www.birthsource.com/scripts/article.asp?articleid=120). Protracted disorders refer to a series of events including protracted active phase dilation (slower than normal rate of cervical dilation) and protracted descent (delayed descent of the fetal head in the active phase). A laboring woman, who has a slower than normal rate of cervical dilation, is said to have a protraction disorder. Diagnostic criteria are 1.2 cm per hour for primips and 1.5 cm per hour for multips. For protracted descent, the criteria are less than 1.0 cm per hour in primips and less than 2.0 cm per hour for multips.

A slow progress may be the result of CPD (cephalopelvic disproportion). Most women, however, benefit greatly from adequate hydration and some nutrition, emotional reassurance, position changes ~ these women may go on and deliver vaginally.

Arrest disorders include secondary arrest of dilation (no progress in cervical dilation in more than 2 hours), arrest of descent (fetal head does not descend for more than 1 hour in primip and more than 0.5 hours in multip), and failure of descent (no descent).

Much of the diagnostic reference for protracted disorders is associated with the Friedman Labor Curve. For the past half-century obstetric practice has followed the description of normal labor set out in a landmark, 500 person study by Dr. Emanuel Friedman.

Friedman established the following definitions of labor progression in 1955:

* Protracted active labor: less than 1.2 cm/hr.
* Active phase at rest: no dilation for 2 hours.
* Protracted descent: less than 1 cm/hr.
* Arrested descent: no descent for 1 hour.

Notes form Jeanette Koshar: The above labor graph is an average. Note the black line is the mean. As with any data, "average" also takes in the 2 standard deviations on either side of the mean. Hence the latent phase average is 6-8 hours, active is 3-6 and transition is 20-40 minutes. The above information is meant to be used as a guide. Look at the whole picture!! How well are the mother and fetus doing?