Managing Complications in Pregnancy and Childbirth: - IAWG

Unsatisfactory progress of labourS-61Figure S-7, page S-61 is a sample partograph showing arrest ofdilatation and descent in the active phase of labour. Fetal distress andthird degree moulding together with arrest of dilatation and descent inthe active phase of labour in the presence of adequate uterinecontractions indicates obstructed labour.• The woman was admitted in active labour at 10 AM:- fetal head 3/5 palpable;- cervix dilated 4 cm;- three contractions in 10 minutes, each lasting 20–40 seconds;- clear amniotic fluid draining;- first degree moulding.• At 2 PM:- fetal head still 3/5 palpable;- cervix dilated 6 cm and to the right of the alert line;- slight improvement in contractions (three in 10 minutes, eachlasting 40 seconds);- second degree moulding.• At 5 PM:- fetal head still 3/5 palpable;- cervix still dilated 6 cm;- third degree moulding;- fetal heart rate 92 per minute.• Caesarean section was performed at 5:30 PM.