First Stage of Labor

Aka: First Stage of Labor, Stage One of Labor, Labor Stages, Friedman Curve, Latent Phase of Labor, Active Phase of Labor

II. Background

  1. Stage 1 of Labor is divided into two phases
    1. Latent Phase
    2. Active Phase
  2. Expected progress is based on Friedman Curve
  3. Assumes regular, frequent palpable contractions

III. Phase: Latent

  1. Definition
    1. Cervical dilation <6 cm and
    2. Regular contractions
  2. Normal Progress
    1. Nulliparous women
      1. Maximum normal duration <20 hours
    2. Multiparous women
      1. Maximum normal duration <14 hours
  3. Management
    1. Avoid hospitalization in latent labor (<4-5 cm dilated, <80% effaced, non-painful contractions)
    2. Maximize hydration
    3. Facilitate rest and supportive environment
    4. Consider latent phase sedation (e.g. Hydroxyzine)
    5. See Non-Pharmacologic Pain Control in Labor

IV. Phase: Active

  1. Definition
    1. Cervical dilation >6 cm and
    2. Regular contractions
  2. Normal Progress
    1. Nulliparous women
      1. Cervical Dilation: >1.2 cm/hour
      2. Fetal Descent: >1 cm/hour
      3. Duration <8.6 hours
    2. Multiparous women
      1. Cervical Dilation: >1.5 cm/hour
      2. Fetal Descent: >2 cm/hour
      3. Duration <7.5 hours
  3. Management
    1. See Labor Dystocia
    2. Consider Active Management of Labor
      1. Oxytocin Augmentation
    3. Consider amniotomy
    4. See Fetal Heart Tracing
    5. See Active Labor Anesthesia

V. References

  1. LeFevre (2021) Am Fam Physician 103(2): 90-6 [PubMed]

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Related Studies

Ontology: Labor Stage, First (C0022871)

Definition (NCI) The stage of the labor and childbirth process when the uterine contractions become strong and regular with cervical effacement and complete dilation of the cervix.
Definition (MSH) Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.
Concepts Temporal Concept (T079)
MSH D007747
SnomedCT 6893006, 289210008
English First Labor Stage, First Stage Labor, Labor Stage, First, Labor, First Stage, Obs first stage labor, Obs first stage labour, first labour stage, labor first stage, first stage of labor, first stage of labour, First Stage of Labor, Dilating Stage, labor stage first (physical finding), labor stage first, First stage of labor, First stage of labour, Observation of first stage of labor, Observation of first stage of labour, Finding of first stage of labor (finding), Finding of first stage of labor, Finding of first stage of labour, First stage of labor (finding)
Portuguese Primeiro Estágio do Trabalho de Parto, Primeiro Período do Trabalho de Parto, Dilatação do Colo do Útero, Dilatação Cervical, Primeira Fase do Trabalho de Parto
Swedish Förlossningens öppningsskede
Czech porodní doba první
Finnish Avautumisvaihe
French Premier stade du travail
Russian RODY, PERVAIA STADIIA, PERIOD RASKRYTIIA, PERIOD REGULIARNYKH SKHVATOK, ПЕРИОД РАСКРЫТИЯ, ПЕРИОД РЕГУЛЯРНЫХ СХВАТОК, РОДЫ, ПЕРВАЯ СТАДИЯ
Spanish primera etapa del trabajo de parto - hallazgo (hallazgo), hallazgo relacionado con la primera etapa del trabajo de parto, hallazgo relacionado con la primera etapa del trabajo de parto (hallazgo), primera etapa del trabajo de parto - hallazgo, Dilatación Cervical, Dilatación del Cuello Uterino, período dilatante (hallazgo), período dilatante, primer período del parto, primer período del trabajo de parto, Primer Periodo del Trabajo de Parto
Polish Okres porodu pierwszy
Japanese 開口期-分娩, 分娩第1期, 分娩開口期, 開口陣痛
German Geburt, erste Phase, Geburtsphase, erste, Eröffnungsperiode
Italian Primo stadio del travaglio di parto
Dutch Bevalling, eerste fase van de, Eerste fase van de bevalling
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: labor stage (C2985268)

Definition (NCI) The various distinct periods of the labor and childbirth process. It involves uterine contractions and cervical dilation to expel the fetus and for the baby to be born.
Concepts Finding (T033)
English Stage of Labor, Stages of Labor, labor stage, labor stage (physical finding)
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: labor stage first early (C3836975)

Concepts Temporal Concept (T079)
English labor stage first early, labor stage first early (physical finding)
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: labor stage first active (C3836976)

Concepts Temporal Concept (T079)
English labor stage first active, labor stage first active (physical finding)
Derived from the NIH UMLS (Unified Medical Language System)

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