Clinical algorithms for identification and management of delay in the progression of first and second stage of labour

J. Pasquale, M. Chamillard, V. Diaz, C. Gialdini, M. Bonet, O. T. Oladapo, E. Abalos, for the W. HO Intrapartum Care Algorithms Working Group, Livia Ciabati, Lariza Laura de Oliveira, Joyce Browne, Marcus Rijken, Sue Fawcus, Justus Hofmeyr, Tippawan Liabsuetrakul, Çağri Gülümser, Anna Blennerhassett, David Lissauer, Shireen Meher, Fernando AlthabeMercedes Bonet, A. Metin Gülmezoglu, Olufemi Oladapo

Research output: Contribution to journalReview articleAcademicpeer-review

3 Citations (Scopus)

Abstract

Aim: To develop clinical algorithms for the assessment and management of slow progress of labour. Population: Low-risk singleton, term, pregnant women in labour. Setting: Institutional births in low- and middle-income countries. Search strategy: We systematically reviewed the literature on normal labour progression, and guidance on clinical management of abnormally slow progression from 1 December 2015 to 1 October 2020 from relevant international guidelines, Cochrane reviews and primary research studies in PubMed by searching for international and national guidance documents, electronic databases and published systematic reviews using relevant keywords. Case scenarios: We developed two clinical algorithms: one for abnormally slow labour progression and arrest during first stage and one for the second stage. The algorithms provide definitions of suspected and confirmed slow progress of labour or arrest, initial assessment and ongoing monitoring, differential diagnosis, and management of the abnormalities, as well as links to other algorithms for labour management. Conclusions: Identifying abnormal progress of labour is often challenging. These algorithms may help healthcare providers identify abnormal labour progress and institute prompt management or referral where needed but also reduce misdiagnosis and unnecessary use of interventions to accelerate labour. Tweetable abstract: Evidence-based clinical algorithms may help and standardize early identification and management of abnormally slow labour progress or arrest.
Original languageEnglish
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Early online date2022
DOIs
Publication statusE-pub ahead of print - 2022

Keywords

  • Abnormal
  • active first stage
  • delay
  • duration
  • dystocia
  • labour
  • length
  • prolonged labour
  • protracted
  • second stage of labour

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