Page 86 - 2023 Elctronic Book (3) Normal Labor_Neat

• Despite immense development in imaging techniques to assist in making

the right decision for the patient nonetheless in labor management the
clinical assessment still has a key role.

 Recommendation

• Precise assessment of onset of labor is crucial to identify any deviation from

normal course.
• Latent phase of labor is when there is painful uterine contraction and some

cervical effacement; dilatation up to 4 cm. The duration may vary days to

weeks.
• The progress of first stage labor: progressive cervical dilatation 2 cm/4 h,

frequency of uterine contraction, progressive descent and rotation of the
head.

• There is no substantial evidence to support the imaging: CT/MRI for routine
pelvic assessment. Clinical trial (labor) is still accepted for pelvic

assessment. Imaging may assist in decision making for labor in woman to
evaluate the pelvis with history of pelvic fracture.

• Monitoring of fetal heart rate should be a routine practice to ensure fetal well
being during the process of labor.

85