Poor progress in labour

Abstract

Labour is a dynamic event characterized by progressive cervical dilatation and descent of the head culminating in vaginal delivery. Prolonged labour is associated with adverse fetal, neonatal and maternal outcome. Partography allows early diagnosis of poor progress of labour. Psychosocial support, hydration, pain relief along with artificial rupture of membranes when required and judicious use of oxytocin to correct slow progress had reduced the adverse consequences of prolonged labour. Prior to augmentation malpresentation and gross disproportion should be excluded and the fetal condition should be optimal. A proportion of cases will fail to progress despite adequate management. Dystocia is an important cause of Caesarean section. Despite initial expectation and enthusiasm, active management of labour has not reduced the Caesarean section rate for dystocia. This article reviews the causes and management options for poor progress in labour.