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Current Management of Labour

Current Management of Labour

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Published by: api-3705046 on Oct 18, 2008
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03/18/2014

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10/22/08
Prof AAE Orhue
1
CURRENT MANAGEMENT OF LABOUR
FIRST STAGE

Defined as stage of cervical os dilatation from zero to 10cms in
which there are painful palpable uterine contractions and exist in
two phases viz latent and active phase.

Latent phase concept: The latent phase marks the cervical os
dilatation from zero till 3cms in primgravida or 4cm in multigravid
associated often with painful, palpable contractions of increasing
frequency and intensity of at least one in 10 minutes interval. It is a
prodromal stage which show much variation in duration and
represents the earliest part of first stage labour which essentially is
innocuous and not predictive if any sinister subsequent Active phase
problems.

Diagnosis: Parturient at term with contractions at least one in every
10/22/08
Prof AAE Orhue
2
CONTD
10 minutes interval and cervical os dilatation less than 3cm in
primigravida or 4cm in multigravida.

Approach to management: In the absence of any other
complications (like post-datism, hypertensive diseases fetal
distress or rupture of membranes) treatment is observation until
conversion to active phase labour.

Classifications:
(e) Normal latent phase when the duration of the latent phase is
within 8 hours before conversion to Active phase
(f) Prolonged latent phase when the latent phase duration is over 8
hours but within 24 hours.

(g) False labour is a latent phase case where the latent phase features persist over 24 hours without conversion to active phase. Thus false labour is the diagnosis in retrospect of a parturient in

10/22/08
Prof AAE Orhue
3
CONTD

whom the latent phase feature is still persisting after 24 hours without
conversion to active phase. False labour may be contractile or non
contractile. Latent phase is a mere pro dromal stage which deserve
treatment with observation only and no intervention in the absence of
any complications.

Active phase concept: This is the later aspect of first stage labour
marking the cervical os dilatation from 3cms in the primigravida or
4cm in the multigravida until full cervical os dilatation at 10cm and
often is the inferred aspect of labour in which strong enough
contraction is generated and sustained to lead on to the delivery of
the fetus and placenta per vagina.

It is characterised by regular, painful palpable contractions of increasing frequency and intensity associated with progressive effacement and dilatation of the cervical os, and descent of the

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