gynecology and obstetrics
Protracted Labor
Treatment
Oxytocin Sometimes operative delivery if the 2nd stage of labor is prolonged Cesarean delivery for fetopelvic disproportion or intractable hypotonic dysfunction , which is the treatment for hypotonic dysfunction. If normal progress is restored, labor can then proceed. If not, fetopelvic disproportion or intractable hypotonic dysfunction may be present, and Cesarean Delivery may be required. If the 2nd stage of labor is prolonged, Operative Vaginal Delivery may be appropriate after evaluation of fetal size, presentation, and station (2 cm below the maternal ischial spines [+2] or lower) and evaluation of the maternal pelvis. The 2nd stage of labor is considered prolonged in the following cases: In nulliparous women: Lack of continuing progress for 4 hours with a regional anesthetic or 3 hours without a regional anesthetic In multiparous women: Lack of continuing progress for 3 hours with a regional anesthetic or 2 hours without a regional anesthetic ( Treatment reference ) Hypertonic uterine dysfunction is difficult to treat, but repositioning, short-acting tocolytics (eg,terbutaline0.25 mg IV once), discontinuation ofoxytocinif it is being used, and analgesics may help. 