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For: Differentiate and Mx
1. Prolonged latent Phase
2. Prolonged active phase
3. Prolonged Second stage
4. Prolonged Third stage

try it

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prolong latent phase.

cervical dilation < 3 for more then 20 hrs in primipara and >14 hrs in multipara.
mx............rest and sedation with narcotics

prolong active phase.

cervical dilation is more the 3 cm but <10 cm ,or there is no change in cervical dilation for then 2 hrs ,or rate cervical dilation is less then 1.2 cm in primipara. and 1.5 cm in multipara.
mx..............hypotonic contractions........oxytocin
hypertonic..............morphine sedation.
if contraction r adecuate or in above cases oxytocin or sedation fails......... cesaraen section.

prolong second stage.
failure to deliver the baby in one hour in primipara or 2 hour in multipara or if pt has received epidural add 1 extra hr.
mx.......I/V oxytocin and pushing ,if fails see wheather head r engaged or not.
if engaged....try forcep or vaccum
if not engaged.....try c/s.

prolong third stage.
failure to remove placenta with in 30 minutes.
mx..manual removal or rarely c/s.