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from Section 6 - Intrapartum/Delivery
Published online by Cambridge University Press: 08 April 2025
This is a case of a 35-year-old gravida 1 para 0 at 39 weeks’ gestation who experienced a protracted active phase of the first stage of labor. The case reviews traditional definitions (based on the work of Friedman) and current Obstetrical Care Consensus guidelines related to the active phase of the first stage of labor. It includes discussion of the 5 Ps that can affect labor progress and interventions that have been shown to have a positive impact on the active phase. Slow but continued progress in the first stage of labor is not an indication for cesarean. To diagnose arrest of dilation in the active phase, the cervix must be ≥ 6 cm dilated with rupture of membranes and ≥ 4 hours of adequate contractions (≥ 200 MvU) or ≥ 6 hours of inadequate contractions.
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