4.4 Prolonged Latent PhaseResearch studies have shown that a prolonged latent phase (variously defined in the literature) is associated with:• Earlier admission to hospital during course of labour• Less time spent in labour at home before the first vaginal examination• Increased risks for obstetric and poor fetal outcome, for example:• Greater use of oxytocin augmentation• More C/S – risk decreases with increasing cervical dilation on presentation for both nulliparous, parous women and women with a previous C/S• Thick meconium• Longer labours• More epidural use• More maternal fever• More obstetric intervention the longer the labour is perceived to be by obstetricians• Higher blood loss post delivery• More low 5-minute Apgar scores and more neonatal resuscitation• More NICU admissions• Longer maternal and neonatal stays.• Nulliparity• History of C/S in parous women• Slow or lack of cervical shortening during a contraction (by ultrasound) and ‘cervical contractions’ on cervimetry• Raised level of pain perception or distress-related thought• Higher levels of anxiety/lack of support at homeIn the 1950’s Friedman studied prolonged latent phase labour and reported that iatrogenic causes included:• use of heavy narcotic-sedative analgesia• regional block anaesthesia