Labour is said to be prolonged when the first and second stage extend arbitrarily beyond:
Correct Answer: 18 hours
Description: Ans: (b) 18 hoursWilliams' Obstetrics, 24th editionFirst Stage of LaborTwo phases of cervical dilatation are defined:Latent phaseActive phaseThe latent phase corresponds to the preparatory division, and the active phase, to the dilatational division.Friedman subdivided the active phase into the:Acceleration phasePhase of maximum slope o Deceleration phaseLatent PhaseThe onset of latent labor, as defined by Friedman (1972), is the point at which the mother perceives regular contractions. The latent phase for most women ends at between 3 and 5 cm of dilatation.Prolonged Latent PhaseFriedman and Sachtleben (1963) defined this by a latent phase exceeding 20 hours in the nullipara and 14 hours in the multipara.Active LaborCervical dilatation of 3 to 5 cm or more, in the presence of uterine contractions, can be taken to reliably represent the threshold for active laborProtraction as a slow rate of cervical dilatation or descent:For nulliparas was less than 1.2 cm dilatation per hour or less than 1 cm descent per hour,For multiparas, protraction was defined as less than 1.5 cm dilatation per hour or less than 2 cm descent per hour.Second Stage of LaborThis stage begins when cervical dilatation is complete and ends with fetal delivery.The median duration it is highly variable but is approximately:50 minutes for nulliparas20 minutes for multiparasThe mean length of first- and second-stage labor was approximately:9 hours in nulliparous women without regional analgesia, and that the 95th percentile upper limit was 18.5 hours.Corresponding times for multiparous women were a mean of 6 hours with a 95th percentile maximum of 13.5 hours.Prolonged LabourLabour is said to be prolonged when the combined duration of first and second stage is more than 18 hoursCauses:Abnormal uterine actionMalpositionMalpresentationMacrosomiaFetal malformationContracted pelvisCephalopelvic disproportionProlonged latent phase-in primi more than 20 hours and in multi more than 14 hoursProlonged active phase-this is the most common. Cervical dilatation less than 1.2 cm/hour in nullipara and less than 1.5 cm/hour in multiparaSecondary arrest of dilatation-there is arrest in cervical dilatation for atleast 2 hoursArrest of descent-there is arrest of descent of fetal head for atleast one hour
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Gynaecology & Obstetrics
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