Recommandations pour l'administration d'oxytocine au cours du travail spontané. Chapitre 1: définition et caractéristiques du travail normal et anormal

Since the 1950s, Friedman's curves served as reference to guide obstetrical practice around the world. However, recent studies have suggested guidelines based on Freidman's results were too stringent and induce inappropriate and excessive interventionism. The committee aimed to redefine the structure and the normal duration of the labor, as well as the criterion to be fulfilled to consider a labor as abnormal. Several recommendations have been produced based on a systematic literature review. Labor dystocia should not be diagnosed during the latency phase. The beginning of the active phase of the 1st stage of labor has been established between 5 and 6 cm of cervical dilatation, which is later than previously suggested. Rate of cervical dilatation is considered as abnormal below 1 cm per 4 hour during the first part of the active phase, and blow 1 cm per 2 hour above 7 cm of dilatation. A maximum duration for the 2nd stage of labor cannot be defined in the French context, based on the literature. However, exceeding 3 hours, the risk-benefit balance becomes less beneficial. These new guidelines would help to reduce the use of oxytocin and caesarian delivery for labor dystocia.