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Questions and Answers
What is a prolonged latent phase of labor defined as?
What is a prolonged latent phase of labor defined as?
- A latent phase that is shorter than 2 hours in a nullipara or 1 hour in a multipara
- A latent phase that is longer than 12 hours in a nullipara or 8 hours in a multipara
- A latent phase that is longer than 20 hours in a nullipara or 14 hours in a multipara (correct)
- A latent phase that is shorter than 6 hours in a nullipara or 4 hours in a multipara
What may occur if the cervix is not 'ripe' at the beginning of labor?
What may occur if the cervix is not 'ripe' at the beginning of labor?
- A prolonged deceleration phase
- A prolonged latent phase (correct)
- A prolonged active phase
- A secondary arrest of dilatation
What is the normal rate of cervical dilatation in a nullipara during the active phase of labor?
What is the normal rate of cervical dilatation in a nullipara during the active phase of labor?
- At least 3.0 cm/hr
- At least 0.5 cm/hr
- At least 2.0 cm/hr
- At least 1.2 cm/hr (correct)
What is the primary cause of a protracted active phase?
What is the primary cause of a protracted active phase?
What is the duration of the active phase in a primigravida if it is prolonged?
What is the duration of the active phase in a primigravida if it is prolonged?
What is the uterine state characterized by ineffective contractions during a prolonged latent phase?
What is the uterine state characterized by ineffective contractions during a prolonged latent phase?
What may be necessary if the cause of the delay in dilatation is fetal malposition or CPD?
What may be necessary if the cause of the delay in dilatation is fetal malposition or CPD?
What is the pressure of ineffective contractions during a prolonged latent phase?
What is the pressure of ineffective contractions during a prolonged latent phase?
What may occur if there is excessive use of an analgesic early in labor?
What may occur if there is excessive use of an analgesic early in labor?
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Study Notes
Dysfunctional Labor in the First Stage
- Dysfunctional labor in the first stage involves prolonged latent phase, protracted active phase, prolonged deceleration phase, and secondary arrest of dilatation.
Prolonged Latent Phase
- Defined as a latent phase longer than 20 hours in a nullipara or 14 hours in a multipara (Friedman, 1978)
- Occurs when cervix is not "ripe" at the beginning of labor, requiring time to prepare for labor
- May occur with excessive use of an analgesic early in labor
- Uterus is in a hypertonic state with relaxation between contractions being inadequate
- Contractions are mild (less than 15 mm Hg on a monitor printout) and ineffective
Protracted Active Phase
- Associated with cephalopelvic disproportion (CPD) or fetal malposition
- May reflect ineffective myometrial activity
- Defined as cervical dilatation not occurring at a rate of at least 1.2 cm/hr in a nullipara or 1.5 cm/hr in a multipara
- Active phase lasts longer than 12 hours in a primigravida or 6 hours in a multigravida
- May require cesarean birth if caused by fetal malposition or CPD
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