Delay in progress in labour

1. Big picture

Delay in progress in labour means labour is not advancing normally in relation to cervical dilatation, fetal descent, fetal rotation, contraction pattern, and maternal–fetal wellbeing.

The examiner wants one core answer:

Do not treat slow labour blindly with oxytocin. First decide whether the problem is poor uterine power or mechanical obstruction.

The safe clinical sequence is:

Slow labour suspected
      ↓
Assess mother + fetus
      ↓
Assess cervix, membranes, contractions, fetal position, station, caput/moulding
      ↓
Ask: hypotonic labour or obstructed labour?
      ↓
If no obstruction and fetus/mother stable → support ± amniotomy ± oxytocin
      ↓
If obstruction, fetal compromise, uterine rupture risk, or failed augmentation → operative delivery

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