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Gerald W. Gustafson, M.D.
JAMA. 1954;155(6):535-538. doi:10.1001/jama.1954.03690240001001.
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Although the problem of prolonged labor is repeatedly discussed at medical meetings, its importance warrants repetition, not only because of the known dangers to both mother and baby but also because concepts of the various factors involved and their management are not constant. No other problem in obstetrics so taxes the patience and judgment of the physician. Even in the best of clinics, an increase in maternal and fetal morbidity and mortality accompanies increase in duration of labor. The definition of prolonged labor varies with different authors, but most agree that labor lasting more than 24 hours with progressive dilatation and effacement should be considered prolonged. This is a prolongation of the first stage except when disproportion, abnormal position, or pelvic tumor blocking the birth canal remains unrecognized. At a recent meeting of the American College of Surgeons, the audience was asked to vote on what they considered to be


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