Protraction of labor during active labor should be managed initially with oxytocin and prostaglandins to assist in cervical ripening.

• A. Not studied
• B. False
• C. True
• D. Only with cesarean

Answer: (C)

Protraction of labor in the active phase means labor isn’t advancing as quickly as expected despite contractions. The first step is augmentation with oxytocin to strengthen contractions and promote progression. If the cervix is not favorable for labor to continue (low Bishop score), cervical ripening with prostaglandins can be added to soften and dilate the cervix, making it easier for contractions to drive labor forward. So starting with oxytocin and using prostaglandins for cervical ripening when indicated is a reasonable initial approach. As always, monitor for signs of hyperstimulation or fetal distress and escalate care if progress does not occur.