n the present study of primigravidae of labour, out of 1100 cases, eight hundred patients were analysed, satisfying the criteria of normal labour. Three hundred patients were excluded as they required either ceasarean section, oxytocin stimulation, or instrumentation for delivery as illustrated in the fol. table;

No. of Patients
%
Total
1100
100
Spontaneous Delivery
800
72.7
Oxytocin Stimulation
220
20
Caesarean Section
88
8
Forceps application
38.5
3.5
Vaccum Extraction
33
3


The eight hundred patients analysed were divided into 8 groups of hundred each, representing each cm of cervical dilatation on admission. Thus the eight nomograms achieved representing normal labour in these patients are shown in the following graphs

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Schematic Representation of
Abnormal Labour Patterns
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Figure 9 represents eight slopes of cervimetric progress in these patients serving as a nomogram of cervical dilatation. If the patients progress strays two hours to the right of the nomogram, labour is adjudged at that stage to be prolonged, requiring acceleration or intervention. The rate of cervical dilatation from time of admission in labour to full dilatation for each of the eight groups has been shown in the table below;
Initial Cervical Dilatation in Cms.
Rate of Dilatation in Cms/Hr
Rate of Time taken for ICM Cervical Dilatation in Hrs/Cm
2
0.850
1.180
3
1.002
0.998
4
0.935
1.069
5
1.137
0.879
6
1.112
0.899
7
1.038
1.038
8
1.040
0.961
9
1.000
1.000
Mean +/- Standard Deviation
1.014 +/- 0.086
1.003 +/-0.09

Initial Cervical Dilatation in Cms.
Mean of Time to Full Dilatation in Hrs.
Std. Dev. of Time in Hrs.
2
4.95
2.17
3
4.22
1.68
4
4.16
1.75
5
2.97
1.21
6
2.64
0.91
7
1.95
0.91
8
1.60
0.67
9
1.00
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Abnormal Patterns of Labour

  • Prolonged Latent Phase - Six hours in primigravidae and four hours in multigravidae is considered prolonged.

  • Primary Dysfunctional Labour
    a) Protracted Active-Phase Dilatation - Labour in which active phase progresses at the rate of less than 1 cm/hr before normal     active slope has been established.
    b) Prolonged Deceleration Phase - Three hours or more.

  • Secondary Arrest of Dilatation - Secondary Arrest of Dilatation occurs when cervical dilatation ceases after a @ portion of active-phase dilatation. It is often due to malposition or deflexion of the presenting part. Minimum of two hours of arrest is needed before diagnosis is confirmed.

  • Precipitate Labour - Maximum slope of dilatation of 5 cm/hr or more.

     

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