Analysis did not begin until women reached 3 cm of dilation, largely because women in spontaneous labor were typically admitted when their cervix had dilated at least 3 cm. The period before 3 cm of dilation seems to be longest when induction of labor occurs in the presence of an unfavorable cervix.
WHAT THIS EVIDENCE MEANS FOR PRACTICE
Harper and colleagues confirm a commonly held perception that women undergoing induction of labor spend a longer total time in labor than women who enter labor spontaneously.3,4 Before 6 cm, women undergoing induction of labor may take as long as 10 hours to achieve each centimeter of dilation. This pattern suggests that a diagnosis of arrest of labor before 6 cm of dilation needs to be scrutinized carefully to prevent unnecessary cesarean delivery.
William F. Rayburn, MD, MBA
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