Abnormal Labor

1st stage (painful contractions leading to cervical dilation)
- Latent Phase (0-6 cm dilation): Protraction of latent phase is defined as greater than 14 hours (multip) or 20 hours (nullip) without change in dilation.
- Active Phase (6-10 cm dilation): Protraction of active phase is defined as ≤1 cm dilation in 2 hr; manage with Pitocin. Arrest is defined as no change in 4 hours (with adequate contractions) or 6 hours (without adequate contractions); management includes placing an IUPC catheter to determine if contractions are adequate, if yes: C-section, if no: AROM or Pitocin.
2nd stage (active pushing)
- Arrest is defined as no change in fetal station in 1-3 hrs (depending on parity and use of neuraxial anesthesia); management is to reduce epidural rate, give Pitocin, consider C-section or forceps delivery.
3rd stage (delivery of the placenta)

Missed Concepts

Obesity is a risk factor for POP, but weight loss is not an effective management option. Instead consider pessary or surgery.
Scuba diving is not recommended during pregnancy.
It's ok to start a new exercise regimen after becoming pregnancy.