Definitions
This stage begins at 10 cm cervical dilation and ends with the birth of the neonate.
What is the second stage of labor?
Beginning of active phase dilation threshold.
What is 6 cm cervical dilation?
Duration (in hours) without cervical change in adequate contractions indicates active phase arrest.
What is 4 hours?
This procedure artificially ruptures membranes to reduce labor duration.
What is amniotomy?
ACOG recommends offering this type of anesthesia at any stage of labor for pain relief.
What is neuraxial anesthesia?
This phase ends when the cervix shows rapid dilation and marks the beginning of the active phase of labor.
What is the latent phase?
The span between onset of labor and full dilation (10 cm) defines this stage.
What is the first stage of labor?
Duration (in hours) without cervical change in inadequate contractions (even with oxytocin) indicates active phase arrest.
What is 6 hours?
Device recommended when contractions can't be accurately monitored externally.
What is the intrauterine pressure catheter (IUPC)?
This should be performed for active phase arrest once defined.
What is cesarean delivery?
This definition refers to no progression in cervical dilation despite interventions like oxytocin augmentation or adequate contractions, in the active phase ≥ 6 cm dilation.
What is active phase arrest?
Nulliparity, LGA, maternal obesity, AMA, OP position, and cephalopelvic proportion are all risk factors of this.
What is protraction and arrest of labor?
This threshold of uterine activity (MVUs) defines "adequate uterine activity."
What is 200 Montevideo Units?
These two strategies (dose-related) are both acceptable to reduce operative deliveries during active labor management.
What are low-dose or high-dose oxytocin regimens?
This type of delivery should be assessed before proceeding to cesarean for second-stage arrest.
What is operative vaginal delivery?
Defined as pushing for more than 3 hours in nulliparous individuals or more than 2 hours in multiparous individuals.
What is prolonged second stage of labor?
Zang et al described this as the active change made in nulliparous patients
What is 0.5-0.7 cm/hr?
This is the statistically significant decreased likelihood of vaginal delivery for nulliparous individuals if second stage exceeds this duration.
What is more than 4 hours of pushing?
Continuous, one-on-one presence of support personnel during labor is known by this term.
What is continuous emotional support?
To diagnose labor arrest in second stage earlier, clinicians should note failure of this fetal progression despite adequate effort.
What is fetal rotation or descent?
This syndrome includes slower-than-normal dilation in the active phase of labor.
What is labor protraction?
This researcher defined the 95th percentile of active phase as 1.2cm/hr in nulliparous patients and 1.5cm/hr in multiparous patients
Who is Friedman?
From Consortium on Safe Labor, this percentile is used to characterize prolonged latent phase duration in nulliparous individuals.
What is the 95th percentile (~16 hours) for latent phase?
A maneuver clinicians may attempt during second-stage dystocia when the fetal head is posterior or transverse to increase vaginal delivery chances.
What is manual rotation?
ACOG recommends this minimum time threshold of oxytocin administration with ruptured membranes before diagnosing failed induction of labor.
What is at least 12–18 hours of oxytocin with ruptured membranes?