Scribd
Upload
79 views1 page

Spontaneous Labor Management Guidelines

This document provides an algorithm for the spontaneous labor process. It outlines the steps from admission through delivery. Women presenting in spontaneous labor with intact membranes and a term, singleton, vertex fetus are assessed. If the cervix is less than 4 cm, the woman is sent home or admitted based on progress. If admitted, labor progress is assessed in the first and second stages. Options depending on progress include augmentation, operative delivery, or vaginal birth. Criteria for arrest of labor are provided.

Uploaded by

Meity Elvina
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
79 views1 page

Spontaneous Labor Management Guidelines

This document provides an algorithm for the spontaneous labor process. It outlines the steps from admission through delivery. Women presenting in spontaneous labor with intact membranes and a term, singleton, vertex fetus are assessed. If the cervix is less than 4 cm, the woman is sent home or admitted based on progress. If admitted, labor progress is assessed in the first and second stages. Options depending on progress include augmentation, operative delivery, or vaginal birth. Criteria for arrest of labor are provided.

Uploaded by

Meity Elvina
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Appendix M

Spontaneous Labor Algorithm

If Maternal or Fetal for Induction of labor:


Medical Indication for TRIAGE See Induction
Admission: DO NOT USE Algorithm (if enters
THIS ALGORITHM active phase, follow
arrow)

- Spontaneous Labor
- Intact membranes
Cervix ≥ 4 cm &
- Stable Mother and Baby in Labor.
- Term, Singleton, Vertex (TSV)
Cervix less *Note: special circumstances such
than 4 cm as severe fatigue, multiple triage
visits, prolonged latent phase, and
difficulty coping may warrant
admission before 4 cm.
(if still less than 4 cm)
Home Walk and Reassess

Admit to L&D

Adequate
Inadequate Progress First
Progress First Stage
Stage

depending on assessment;
home, Arom and/or oxytocin, Inadequate Adequate
Progress Progress
or Cesarean Second Stage Second Stage
(acog criteria for arrest of Labor: at least 6 cm
dilation with ruptured membranes, AND at least
4 hours of adequate contractions without
cervical change or 6 hours of oxytocin with
inadequate contractions and no cervical change)

AROM and/or Oxytocin if


Vaginal Delivery
not already done

Inadequate Adequate
Progress Progress

Operative Delivery or Cesarean Delivery Vaginal Delivery


(ACOG criteria for 2nd Stage Arrest: at least 3 hours
of pushing for nulliparas, at least 4 hours of pushing
for nulliparas with epidural; at least 2 hours of
pushing for multiparas, at least 3 hours of pushing
for multiparas with epidural)
CMQCC Toolkit to Support Vaginal Birth
Adapted with permission from Washington State Hospital Association and Reduce Primary Cesareans

You might also like