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Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. [1] Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children. [1] Failure to progress can take place during two different phases; the latent phase and active phase of labor. [1]
The average time from delivery of the baby until complete expulsion of the placenta is estimated to be 10–12 minutes dependent on whether active or expectant management is employed. [61] In as many as 3% of all vaginal deliveries, the duration of the third stage is longer than 30 minutes and raises concern for retained placenta. [62]
Labor is divided into three stages. First stage of labor starts with the onset of contractions and finishes when the cervix is fully dilated at 10 cm. [15] This stage can further be divided into latent and active labor. The latent phase is defined by cervical dilation of 0 to 6 cm. The active phase is defined by cervical dilation of 6 cm to 10 cm.
Latent phase: 0–3 centimeters; Active labor: 4–7 centimeters; Transition: 8–10 centimeters; Complete: 10 centimeters. Delivery of the infant takes place shortly after this stage is reached (although the mother does not always push right away.)
Labor is separated into 4 stages. The first stage involves latent phase and active phase separated by the dilation of the cervix for 6 to 10 cm. The second stage is the pushing stage. The third stage involves the delivery of the placenta. And the last stage is the contraction of the uterus. [21]
In Africa and Asia obstructed labor affects between two and five percent of deliveries. [8] In 2015 about 6.5 million cases of obstructed labour or uterine rupture occurred. [ 5 ] This resulted in 23,000 maternal deaths down from 29,000 deaths in 1990 (about 8% of all deaths related to pregnancy ).
In comparison to women in spontaneous labor, women in induced labor on oxytocin experience a longer latent phase, however the duration of labor after reaching active labor (when the cervix has reached 6 cm), the duration of labor is considered equal.
Montevideo units are a method of measuring uterine performance during labor. They were created in 1949 by two physicians, Roberto Caldeyro-Barcia and Hermogenes Alvarez, from Montevideo, Uruguay. They are exactly equal to 1 mmHg within 10 minutes.