Indications for a c-section during labor

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  1. Nonreassuring fetal heart tracing
    Category 2-remote from delivery
    Minimal/absent variability is most significant predictor of fetal acidemia
    Category 3 any time is emergent deliver
  2. Failed IOL
    Many different definitions: Most commonly 12-24hrs ruptured membranes on pitocin without active labor
  3. Arrest of dilation
    Can only meet criteria once in active labor 6cm or greater
    Do you know if her contractions are adequate? IUPC with MVUs>200-250
    If the contractions are adequate, no change over 4hrs
    If contractions are inadequate or no IUPC, no change over 6hrs
  4. Arrest of descent
    Prime with epidural 3hrs
    Prime without epidural-2hrs
    Mutlip with epidural 2hrs
    Multip without epidural 1hr
  5. Cord prolapse
  6. Malpresentation
    -Breech, transverse, compound