Obstetrics Book

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Active Management of LaborAka: Labor Dystocia Management

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  1. See Also
    1. Labor Dystocia
    2. Labor Dystocia Prevention
  2. Indications
    1. Failure to Progress
  3. 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
  4. 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
  5. Management: Dystocia refractory to above management
    1. Consider Cesarean section
  6. Preventive Measures
    1. See Labor Dystocia Prevention
  7. 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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