Inconsistent definitions of prolonged labor in international literature: a scoping review

Wouter Bakker*, Evelien M. Sandberg, Sharon Keetels, Jan W. Schoones, Monica Lauridsen Kujabi, Nanna Maaløe, Salome Maswime, Thomas van den Akker

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Objective: Prolonged labor is the commonest indication for intrapartum cesarean section, but definitions are inconsistent and some common definitions were recently found to overestimate the speed of physiological labor. The objective of this review is to establish an overview of synonyms and definitions used in the literature for prolonged labor, separated into first and second stages, and establish types of definitions used. Data sources: A systematic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, Emcare, and Academic Search Premier. Study eligibility criteria: All articles in English that (1) attempted to define prolonged labor, (2) included a definition of prolonged labor, or (3) included any synonym for prolonged labor, were included. Methods: Data on study design, year of publication, country or region of origin, synonyms used, definition of prolonged first and/or second stage, and origin of provided definition (if not primarily established by the study) were collected into a database. Results: In total, 3402 abstracts and 536 full-text papers were screened, and 232 papers were included. Our search established 53 synonyms for prolonged labor. Forty-three studies defined prolonged labor and 189 studies adopted a definition of prolonged labor. Definitions for prolonged first stage of labor were categorized into: time-based (n=14), progress-based (n=12), clinician-based (n=5), or outcome-based (n=4). For the 33 studies defining prolonged second stage, the majority of definitions (n=25) were time-based, either based on total duration or duration of no descent of the presenting part. Conclusions: Despite efforts to arrive at uniform labor curves, there is still little uniformity in definitions of prolonged labor. Consensus on which definition to use is called for, in order to safely and respectfully allow physiological labor progress, ensure timely management, and assess and compare incidence of prolonged labor between settings.

Original languageEnglish
Article number100360
Pages (from-to)1-20
Number of pages20
JournalAJOG Global Reports
Volume4
Issue number3
Early online date5 Jun 2024
DOIs
Publication statusPublished - Aug 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Keywords

  • active support of labor
  • definition
  • labor dystocia
  • labor management
  • labor progress
  • partograph
  • prolonged first stage of labor
  • prolonged second stage of labor

Fingerprint

Dive into the research topics of 'Inconsistent definitions of prolonged labor in international literature: a scoping review'. Together they form a unique fingerprint.

Cite this