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First Stage of LaborAka: Stage One of Labor, Labor Stages, Friedman Curve, Latent Phase of Labor, Active Phase of Labor

See Also
1. Labor Dystocia
Background
1. Stage 1 of Labor is divided into two phases
  1. Latent Phase
  2. Active Phase
2. Expected progress is based on Friedman curve
3. Assumes regular, frequent palpable contractions
Phase: Latent
1. Definition
  1. Cervical dilation <4 cm and
  2. Regular contractions
2. Normal Progress
  1. Nulliparous women
    1. Mean duration: 8.6 hours
    2. Maximum normal duration: 20 hours
  2. Multiparous women
    1. Maximum normal duration: 14 hours
3. Management
  1. Avoid hospitalization in latent labor
  2. Maximize hydration
  3. Facilitate rest and supportive environment
  4. Consider latent phase Sedation (e.g. Hydroxyzine)
  5. See Non-Pharmacologic Pain Control in Labor
Phase: Active
1. Definition
  1. Cervical dilation >4 cm and
  2. Regular contractions
2. Normal Progress
  1. Nulliparous women
    1. Cervical Dilation: >1.2 cm/hour
    2. Fetal Descent: >1 cm/hour
  2. Multiparous women
    1. Cervical Dilation: >1.5 cm/hour
    2. Fetal Descent: >2 cm/hour
3. Management
  1. See Labor Dystocia
  2. Consider Active Management of Labor
    1. Oxytocin Augmentation
  3. Consider amniotomy

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This page was written by Scott Moses, MD. This page was last revised on 10/11/2008 2:27:43 PM. This page was last published on 2/26/2010. 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.