Question

Marvis is a 29-year-old G1P0 in labor at 40 weeks of gestation. She was admitted at 0200 with a history of contractions since 2200 the night before. On admission, she denied spontaneous rupture of membranes or vaginal bleeding. She felt good fetal movement. Her vital signs and the fetal heart rate were normal. Her contractions were every 6 minutes and lasting 30 seconds. Her cervical examination was 2 cm/70%/−2 vertex. It is now 0600 and she has been reexamined. Her cervical examination is now 3 cm/90%/−2 vertex. Her contractions are now every 4 to 5 minutes lasting 60 seconds. She states they are still mild. Marvis has stated that she wants a natural unmedicated birth.

It is now 1000, and Marvis states the contractions have become much stronger. She now needs to use breathing techniques to cope with the contractions. She declines pain medication. Her cervical examination is now 5/100/0. What stage of labor is Marvis in at this time?

Answer 1

The cervical assessment of the patient shows 5cm cervical dilation, 100% effacement and station of head at 0. She is in active phase of first stage of labor.

Stages of labor:

Stage 1:

Onset of regular uterine contractions till the time of attainment of 10 cm cervical dilation. This stage of labor is further divided into 3 phases.

Early phase: onset of labor till cervical dilation of 3 cm is attained

Active phase: 3cm cervical dilation till 7cm cervical dilation

Transition phase: 7cm to 10cm cervical dilation

Stage 2:

Attainment of 10 cm dilation till delivery of baby

Stage 3:

Delivery of placenta

It can be managed either passively or actively. Active management includes administration of uterotonic, early cord clamping and controlled cord traction.