Managing Complications in Pregnancy and Childbirth: - IAWG

UNSATISFACTORY PROGRESS OF LABOUR S-57PROBLEMS• The latent phase is longer than 8 hours.• Cervical dilatation is to the right of the alert line on the partograph.• The woman has been experiencing labour pains for 12 hours ormore without delivery (prolonged labour).GENERAL MANAGEMENT• Make a rapid evaluation of the condition of the woman and fetusand provide supportive care (page C-57).• Test urine for ketones and treat with IV fluids if ketotic.• Review partograph (page C-65).DIAGNOSISTABLE S-10Diagnosis of unsatisfactory progress of labourFindingsCervix not dilatedNo palpable contractions/infrequent contractionsCervix not dilated beyond 4 cm after 8 hours ofregular contractionsCervical dilatation to the right of the alert line on thepartograph (Fig S-6, page S-59)• Secondary arrest of cervical dilatation and descentof presenting part in presence of good contractions• Secondary arrest of cervical dilatation and descentof presenting part with large caput, third degreemoulding, cervix poorly applied to presenting part,oedematous cervix, ballooning of lower uterinesegment, formation of retraction band, maternaland fetal distress (Fig S-7, page S-61)• Less than three contractions in 10 minutes, eachlasting less than 40 seconds (Fig S-8, page S-63)DiagnosisFalse labour, page S-64Prolonged latent phase,page S-64Prolonged active phase,page S-65• Cephalopelvicdisproportion, pageS-65• Obstruction, page S-66• Inadequate uterineactivity, page S-66