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[Labor duration: from normality to dystocia]
1Service de gynécologie-obstétrique, hôpital Louis-Mourier, DHU risques et grossesse, AP-HP, 178, rue des Renouillers, 92700 Colombes, France.
"Normal" labor has been surprisingly little studied in the past 60 years even though it is a central axis in obstetrics. Standards were proposed 60 years ago by Emmanuel Friedman and adopted by many countries to become then, driven from Dublin school, the conditions allowing the management of labor: rupture of membranes and oxytocin with, in case of failure for dynamic dystocia, cesarean. Recent data have suggested that labor duration had changed since the 1960s. Changes in women's characteristics and in obstetric practice especially with the widespread use of oxytocin and realization of epidural may have an impact on labor duration. Current studies suggest that it may be possible to authorize longer labor duration without significant increase in maternal or neonatal morbidity. However, it is premature to change practices following the latest American recommendations without prior studies.
"Normal" labor has been surprisingly little studied in the past 60 years even though it is a central axis in obstetrics. Standards were proposed 60 years ago by Emmanuel Friedman and adopted by many countries to become then, driven from Dublin school, the conditions allowing the management of labor: rupture of membranes and oxytocin with, in case of failure for dynamic dystocia, cesarean. Recent data have suggested that labor duration had changed since the 1960s. Changes in women's characteristics and in obstetric practice especially with the widespread use of oxytocin and realization of epidural may have an impact on labor duration. Current studies suggest that it may be possible to authorize longer labor duration without significant increase in maternal or neonatal morbidity. However, it is premature to change practices following the latest American recommendations without prior studies.
