Dysfunctional or prolonged labor refers to prolongation in the duration of labor, typically in the first stage of labor. Diagnosis of delay in labor is dependent on careful monitoring of uterine contraction intensity, duration and frequency, cervical dilation and descent of the fetus through the pelvis.
Dysfunctional labor can be due to abnormalities in uterine contraction and/or lack of ability of the mother to forcibly expel the fetus, a large fetus and/or an unusual orientation of the fetus in the uterus, or abnormalities in the pelvis such that the passage is blocked or too small.
Classically, six dysfunctional labor patterns are defined, including (1) prolonged latent phase, (2) protracted active phase dilation, (3) secondary arrest of dilation, (4) prolonged deceleration phase, (5) protracted descent, and (6) arrest of descent (see Fig.
Abnormal labor patterns in the first and second stage are defined as either protraction or arrest disorders. Protracted labor stages indicate that labor is progressing but at a slower pace than expected. Arrest disorders indicate the complete cessation of the progress of labor.
When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
Ovulatory dysfunction (AUB-O)—abnormal bleeding because you are not ovulating regularly. Endometrial (AUB-E)—abnormal bleeding because of a problem with the lining of your uterus like an infection.
First-time mothers should expect contractions every five minutes, lasting a minute each. When this rhythm has lasted longer than two hours its time to call your doctor and get ready to have your baby.
Many women experience what is known as "false" labor pains or Braxton Hicks contractions. These irregular uterine contractions are perfectly normal and generally start during your third trimester of pregnancy.
Second Stage or Active Labor
The second stage is the most painful stage of labor. The baby passes through the cervix, through the pelvis and birth canal, and out through the vaginal opening. On average, it takes one to three hours from the time that the cervix becomes fully dilated to the birth of the baby.
What is the second stage of labor? The first stage of labor ends and the second stage begins when your cervix is 10 centimeters dilated. This is usually the most difficult stage of labor because you start trying to push your baby out. It can last anywhere from half an hour to several hours.
It may last up to 2 to 3 days. Contractions are mild to moderate and shorter (about 30 to 45 seconds). You can usually keep talking during them. Contractions may also be irregular, about 5 to 20 minutes apart.
Maternal risk factors that increase the risk for prolonged labour include primiparity [11] and total maternal weight gain or high body mass index [12,13]. Foetal risk factors include a heavy birth weight, large head circumference and occiput posterior presentation [14,15].
During labor, intense contractions of the uterus help move the baby down and eventually out of the pelvis, and into the vagina. These contractions put pressure on the cervix and cause it to expand slowly. Contractions tend to get stronger, closer together, and more regular as labor progresses.
The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery. The first stage of labor and birth occurs when you begin to feel persistent contractions.
Topic Overview. At the end of the third trimester, the baby settles, or drops lower, into the mother's pelvis. This is known as dropping or lightening. Dropping is not a good predictor of when labour will begin. In first-time mothers, dropping usually occurs 2 to 4 weeks before delivery, but it can happen earlier.
Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation. This is because the weight of the baby applies pressure to the cervix.
What Is It? Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a woman's normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle's hormonal signals get thrown off.
Dysfunctional uterine bleeding occurs when the normal cycle of menstruation is disrupted, usually due to anovulation (failure to ovulate) that's unrelated to another illness. Ovulation failure is the most common type of DUB in adolescents and in women who are reaching perimenopause.
If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.
Try being upright
One of your biggest allies is gravity. When you are upright—standing, sitting or kneeling—the weight of your baby presses on the cervix, encouraging it to open. An upright position may also help get your baby into the best position for birth.
Can you feel your cervix dilating? As your cervix starts to thin and soften, you may or may not notice twinges and sensations in that area of your pelvis. This can be as much you trying to convince yourself something is happening though!