Spontaneous latent phase labour: A review of issues in definition, classification and management options

Abstract

Latent phase labour has been a subject of controversy since the time of the original concept over 5 decades ago by Friedman and this controversy is still persisting till date. There is presently so much of new knowledge of labour which when applied to latent phase may clear several of the grey areas particularly in the definition and diagnosis. However, there is still substantial debate and heat in the areas of classification and the management of latent phase where for now there is still no consensus. This review has attempted to throw more light on the grey areas in the
definition and diagnosis by reviewing the original studies by Friedman, Hendricks and O'Driscoll who are the lead scholars in the evolutionary history of latent phase labour. The studies of several other workers in the debate on classification and management were critically review with a view to evolve a consensus. It is finally concluded that nowadays latent phase labour is a clinically recognizable entity with clear cut features and parameters for a prospective diagnosis. Also in spite of the current debate, it is suggested that latent phase which is only the earlier aspect of 1st stage labour, be classified as a continuum consisting of normal latent phase, prolonged latent phase and false labour. By this type of classification, false labour is not a differential diagnosis but a continuum of prolonged latent phase. Based on the knowledge that latent phase of whatever classification is merely yet the earlier aspect of first stage labour, the management should be passive observation until transformation into active phase labour in the absence of any associated complication either before or during the observation. This is the best option to avoiding or
evoking further problem from what is a normal occurrence.