Early detection of abnormal labor using the Friedman labor graph.

Early recognition and appropriate management of abnormal labor can reduce perinatal mortality and morbidity and lower the cesarean section rate. A simple labor graph devised over 25 years ago and later modified makes labor abnormalities easy to detect; the two main divisions of labor, the latent and active phases, are easily recognized. A prolonged latent phase has no serious effects on mother or fetus, but protraction and arrest disorders of the active phase--eg, protracted cervical dilatation, arrest or failure of descent of the presenting part--may have a deleterious effect. Common causes of a prolonged latent phase include false labor and inappropriate use of analgesia and anesthesia. Fetopelvic disproportion and fetal malposition are common causes of disorders of the active phase.