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Active Management of LaborAka: Labor Dystocia Management

See Also
1. Labor Dystocia
2. Labor Dystocia Prevention
Indications
1. Failure to Progress
Management: Stage One
1. See Labor Coaching
2. Consider Active Management of Labor
  1. See Oxytocin Augmentation
3. Consider amniotomy
4. Consider extending definitions of arrested labor
  1. Delaying C-section until 4 hours without dilation
  2. Typically were indicated at 2 hours without change
Management: Stage 2
1. Consider Oxytocin Augmentation
2. Avoid exhausting mother early
  1. Consider not pushing until involuntary urge to push
  2. Consider waiting until vertex approaches introitus
3. Consider Assisted Delivery
  1. Vacuum Assisted Delivery
  2. Forceps Assisted Delivery
4. Consider correction of malposition: Occiput Posterior
  1. Maternal position change
    1. Position mother curling forward from hips
  2. Manual Rotation in Occipitoposterior Presentation
Management: Dystocia refractory to above management
1. Consider Cesarean section
Preventive Measures
1. See Labor Dystocia Prevention
References
1. Shields (2000) ALSO, F:1-14
2. Peaceman (1996) Am J Obstet Gynecol 175(2):363
3. Shields (2007) Am Fam Physician 75(11):1671

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.