A nulliparous woman in spontaneous labor was examined by you at 2pm and was found to be 6 cm dilated, 80% effaced with absent membranes, clear liquor and fully effaced cervix and vertex at 0 station and oxytocin was started to augment the contractions. At 6pm, she is reassessed and found to have same findings, but now with a caput formation and grade 3 moulding. Her contractions were seen to have been adequate for the last 4 hrs. What is the next step?
Ans. C. Shift her to OT for caesareana. The woman is diagnosed with arrest of active stage of laborb. ACOG has updated the definition of arrest of 1st stage of labor in woman undergoing spontaneous labor to decrease the incidence of first caesarean section.c. Arrest in dilatation in active labor is defined at more than or equal to 6cm dilatation, with membrane rupture with no cervical change and one of the following:d. 4 hours or more of adequate uterine contractions (more than 200 Montevideo Units) ORe. 6 hours or more of inadequate uterine contractions
Wait and watch for another two hours
Oxytocin augmentation
Shift her to OT for caesarean
Vacuum delivery
Miscellaneous (Obs)