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Rapid labor
Last reviewed: 08.07.2025
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Definition: According to the definition of E. Friedman (1978), the 95th percentile for the rate of cervical dilation corresponds to 6.8 cm/h in primiparous women and 14.7 cm/h in multiparous women.
For the rate of descent of the presenting part of the fetus, these limits are 6.4 and 14.0 cm, respectively. Therefore, for practical purposes, it should be considered that rapid labor (not to be confused with rapid birth) is characterized by the rate of dilation of the cervix and descent of the presenting part of the fetus exceeding 5 cm/h in primiparous women and 10 cm/h in multiparous women. In most cases, rapid dilation of the cervix and rapid descent of the presenting part of the fetus occur simultaneously.
Diagnosis: Usually, the diagnosis of precipitous labor is made retrospectively by analyzing the labor progression curve.
Causes. The etiologic factors leading to the development of this complication are unclear. In this disorder of labor, the trigger may be stimulation of contractions with oxytocin, although in large series of studies only 11.1% of women with precipitous labor received oxytocin treatment.
Prognosis. The prognosis for vaginal delivery is good. Sometimes labor is too rapid, resulting in the fetus being born in bed. After delivery, the obstetrician should carefully examine the cervix for possible tears, which are common in precipitous labors.
The prognosis for the fetus and newborn should be discussed with caution. Often the fetus cannot tolerate hypoxia caused by frequent and powerful contractions of the uterus. As a result, this leads to the development of a threatening condition of the fetus during labor, suppression of the vital functions of the newborn and to hyaline membrane disease.
Prevention of abnormalities of labor activity should begin long before delivery. It is important to implement measures on hygiene of childhood and school age (rational diet, physical education), ensuring the harmonious development of the female body. During pregnancy, it is necessary to implement hygiene measures, adequate nutrition, in the second half of pregnancy - wearing a bandage. Pregnant women need to undergo a full course of physiopsycho-prophylactic preparation for childbirth, and prescribe vitamins.
All pregnant women who are considered to be at risk of developing labor anomalies should be hospitalized in advance in the pregnancy pathology department, no later than 38 weeks. From the 38th week of pregnancy, comprehensive preparation for childbirth is prescribed. If after 2 weeks of comprehensive preparation for childbirth, the cervix remains immature by the 40th-41st week of pregnancy, the labor management plan should be revised in favor of delivery by cesarean section, taking into account the complicating factors on the basis of which the pregnant woman was included in the risk group for developing labor anomalies.
Management of rapid labor
If a diagnosis of precipitous labor is made before the fetus is born, especially if fetal monitoring reveals signs of distress (suffering), it is necessary to suspend the development of labor using beta-adrenergic agents. Terbutaline (0.00025-0.0005 g intravenously) or ritodrine (0.0003 g/min intravenously) are effective agents that reduce the frequency, duration, and strength of uterine contractions.
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