OBSadvanced
Explain how the 3 Ps can be used to organize an assessment of poor labour progress.
Answer
Assess Power by evaluating contraction frequency, duration, and intensity; Passenger by evaluating fetal lie, presentation, position, attitude, and size; and Passage by considering the pelvic dimensions and maternal soft tissues, including the cervix. Determine which factor or factors may be limiting progress.
Explanation
The 3-P framework organizes assessment rather than assuming that every delay has the same cause. Inefficient contractions suggest a power issue; malposition, malpresentation, or fetal size concerns involve the passenger; and pelvic or soft-tissue limitations involve the passage. More than one factor may contribute. **Key takeaway:** Identify the relevant P before selecting management.\n\n**Glossary:** **Malpresentation**: a presentation other than the expected vertex; **intensity**: strength of a contraction.
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