PREGNANCY-BIRTH Messages for March, 1999: Re: labor augmentation

Re: labor augmentation

From: William D. McIntosh, MD (anonymous@obgyn.net)
Sat, 27 Mar 1999 11:04:27 -0600 (CST)

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In reply to: reb: "labor augmentation"

At Fri, 26 Mar 1999, reb wrote: >
>In recent conversation, our dr's partner said that she would not allow
>me to go beyond 2 - 2 1/2 hrs with failure to progress in labor at 5 cm
>or greater... that it posed a risk to uterus to stay in that state for
>too long and could require hysterectomy. As we are trying for natural
>childbirth, I was disappointed to hear her approach. It feels rather
>arbitrary... and perhaps very conservative, to help Dr. avoid
>potential litigation. Are there any articles which support or oppose
>her position?

This is a standard concern, and is based on considerable research, most famously by Dr. Freidman. This is not grounds to immediatly proceed to C/S in my opinion, but it is important to access the situation, and respond if there is any problem. Impacted labor (adequate contractions without cervical change) is particularly dangerous to both mother and child. Desultory labor (failure of cervical change due to weak contractions) is not so dangerous in the short term, but since the point of labor is to deliver the child, and that goal is not being accomplished, your doctor is correct to be concerned. Augmentation is easy, and very, very effctive. Note, we are talking about the active phase of labor, after 4cm dilation. The latent phase of labor, the first 4cm takes as long as it takes. If the active phase is not progressing, there is something wrong. Whatever is wrong may not need therapy or intervention, but it warrants evaluation. It is a giant red flag.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

Next message: William D. McIntosh, MD: "Re: cervical changes after chilbirth"
Previous message: William D. McIntosh, MD: "Re: Molar pregnancy and sex of future children"
In reply to: reb: "labor augmentation"

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