Managing Complications in Pregnancy and Childbirth: - IAWG

C-72 Normal labour and childbirthPROGRESS OF FIRST STAGE OF LABOUR• Findings suggestive of satisfactory progress in first stage oflabour are:- regular contractions of progressively increasing frequencyand duration;- rate of cervical dilatation at least 1 cm per hour during theactive phase of labour (cervical dilatation on or to the left ofalert line);- cervix well applied to the presenting part.• Findings suggestive of unsatisfactory progress in first stage oflabour are:- irregular and infrequent contractions after the latent phase;- OR rate of cervical dilatation slower than 1 cm per hour duringthe active phase of labour (cervical dilatation to the right ofalert line);- OR cervix poorly applied to the presenting part.Unsatisfactory progress in labour can lead to prolonged labour (TableS-10, page S-57).PROGRESS OF SECOND STAGE OF LABOUR• Findings suggestive of satisfactory progress in second stage oflabour are:- steady descent of fetus through birth canal;- onset of expulsive (pushing) phase.• Findings suggestive of unsatisfactory progress in second stage oflabour are:- lack of descent of fetus through birth canal;- failure of expulsion during the late (expulsive) phase.PROGRESS OF FETAL CONDITION• If there are fetal heart rate abnormalities (less than 100 or morethan 180 beats per minute), suspect fetal distress (page S-95).