Department of Obstetrics and Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, United States.
Semin Perinatol. 2020 Mar;44(2):151215. doi: 10.1016/j.semperi.2019.151215. Epub 2019 Nov 23.
Norms used to describe and evaluate the first stage of labor have been historically based upon data from the middle of the twentieth century. More recent data has characterized the normal first stage of labor differently including that the latent phase of labor is longer not transitioning from latent to active labor until about 6 cm of cervical dilation in a majority of women, regardless of parity or whether labor was spontaneous or induced. Additionally, the amount of time that can take for progress to be made in active labor be longer than previously understood. These two factors would lead to a change in management with the diagnosis of arrest of the first stage of labor being made at 6 cm cervical dilation or beyond in the setting of ruptured membranes and no cervical change for at least 4 h of adequate contractions or 6 h of inadequate contractions.
用于描述和评估第一产程的标准在历史上一直基于 20 世纪中期的数据。最近的数据对正常的第一产程有不同的描述，包括潜伏期更长，大多数女性直到宫颈口扩张 6 厘米时才从潜伏期进入活跃期，无论其是否经产妇、产程是否自发或诱导。此外，活跃期进展所需的时间可能比以前认为的要长。这两个因素会导致管理方式发生变化，即在胎膜破裂且宫颈无变化的情况下，如果宫缩充分 4 小时或宫缩不足 6 小时时，宫颈扩张 6 厘米或以上即可诊断为第一产程停滞。
