Evidence-based guidelines in labor management

Obstet Gynecol Surv. 2014 Apr;69(4):209-17. doi: 10.1097/OGX.0000000000000057.

Abstract

Evidence-based care of women in labor requires a thorough understanding of both "normal" and abnormal labor progress. In response to the growing cesarean delivery rate for dystocia at our institution, a multidisciplinary team of attending physicians, nurse-midwives, resident physicians, and nurses was established to review the literature and create evidence-based guidelines. This article describes the background literature and consensus guidelines reached for the diagnosis of active phase labor, active phase arrest, second-stage arrest, protraction of the active phase, and failed induction of labor. Our review illustrates that slower labor patterns than traditionally described often result in a vaginal delivery without unacceptable increases in maternal or neonatal morbidity.

Publication types

  • Review

MeSH terms

  • Adult
  • Delivery, Obstetric / methods*
  • Education, Medical, Continuing
  • Evidence-Based Medicine / methods*
  • Female
  • Humans
  • Labor, Induced / methods*
  • Labor, Obstetric / physiology*
  • Pain Management / methods*
  • Practice Guidelines as Topic*
  • Pregnancy