Traditional mismanagement of labour – What can we do?. Dan Farine MD Professor of Ob/Gyn & Medicine Head of Maternal Fetal Medicine University of Toronto. The issues in L&D. Fetal distress - <2% of labours Non progressive labour and Oxytocin use – 40-50%
Traditional mismanagement of labour – What can we do?
Dan Farine MD
Professor of Ob/Gyn & Medicine
Head of Maternal Fetal Medicine
University of Toronto
- Up to 6 cm (Bergsjo1982)
- Average 1-2 cm (Phelps 1995)
Stretching during examination?
Misdiagnosed position in 61% (defined as + 45 degrees)Sherer et al. 2001
Misdiagnosed 46% of occipito posterior/ transverse – Prior to forceps.
Potential misapplication in 25%
Akmal & Nicolaides 2003
Carollo et al. 2004
Residents 50-88% Staff: 36-80%
Dupuis et al. 2004
External anatomical marker
Fetal head marker
The cervix started to oscillate around 4-5 cm