Median duration is 50 minutes for nulliparas and 20 minutes for multiparas.Two phases of cervical dilatation:Latent Phase – corresponds to the preparatory divisionPoint at which the mother perceives regular contractions3-5cm dilatationActive Phase – subdivided into:Acceleration PhasePhase of Maximum SlopeDecceleration Phase.Commence with the deceleration phase of cervical dilatation Functional Labor Division:Preparatory Divisioncervix dilates littles, connective tissue components change considerablySedation and conduction of analgesia are capable of arresting this labor divisionDilatation Divisiondilatation proceeds at its most rapid rateUnaffected by sedationPelvic Divisiona.Nulliparas- engagement may take place before the onset of labor, and further descent may not follow until the onset of the 2nd stageMultiparas – descent usually begins with engagement.Asynclitism – lateral deflection to a more anterior or posterior position in the pelvisAnterior asynclitism – the sagittal suture approaches the sacral promotory, more of the anterior parietal bone presents itself to the examining fingers.Posterior asynclitism – the sagittal suture lies close to the symphysis, more of the posterior parietal bone will presentIf severe, the condition, is a common reason for CPD even with an otherwise normal sized pelvis.LM1:Breech – sensation of a large, nodular massHead – hard and round, mobile and ballotableLM2:Hard resistant structureNumerous small, irregular, mobile partsLM3:Not engaged – movable massEngaged.The acromion may be directed anteriorly or posteriorly and superiorly or inferiorly.It is impossible to differentiate exactly the several varieties of shoulder presentation by clinical examination and serves no practical purpose.More practically it may be written as transverse lie or shoulder presentation with back up or back down which is clinically important when deciding the incision type for cesarean delivery.
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