Perils of the new labor management guidelines.

摘要: Recent guidelines issued jointly by the American College of Obstetricians and Gynecologists Society for Maternal-Fetal Medicine assessing labor progress differ substantially from those described initially Friedman, which have guided clinical practice decades. The are based on results obtained new untested methods analyzing patterns cervical dilatation fetal descent. Before these adopted into practice, unconventional analytic approaches should be validated shown to superior, or at least equivalent, currently accepted standards. indicate originally Friedman incorrect and, further, inapplicable modern obstetric practice. We contend that original descriptions normal abnormal progress, were direct observations, accurately describe in descent, differences reported more recently likely attributable patient selection potential inaccuracy very high-order polynomial curve-fitting methods. evaluation is a process serially estimating likelihood safe vaginal delivery. Because many factors contribute likelihood, such as cranial molding, head position attitude, bony architecture capacity pelvis, graphic never used isolation. heavily unvalidated notions ignore parameters remain cornerstones intrapartum decision-making.