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What is A female at 37 wks of gestation has mild labour pain for 10 hours and cervix is persistently 1CM dilated but non effaced. What will be the next appropriate management? and explain in detail?
This is a nulliparous patient and is in latent phase of labor. Latent phase duration normally in a nulliparous female is less than 20hrs and in a multiparous female its is 14 hours. The optimal treatment for this patient is administer sedation and observe the patient. Prolonged latent phase occur when the duration exceeds the above parameters. It could be due to unripe cervix, false labor or sedation. Prolonged first stage of labor occur when cervix dilates less than 1 cm/hr in nulliparous women and less than 1.5cm/hr in multiparous women. Management of prolonged first stage includes observation, augmentation by amniotomy or oxytocin, and continuous suppo. Cesarean delivery is warranted if maternal or fetal status become non reassuring. Ref: Obstetrics and Gynecology edited by Charles R. B. Beckmann page 106