Understanding Arrest of Dilation, also known as Arrested Active Phase of Labor or Failure to Progress in Active Labor, is crucial for accurate clinical documentation and medical coding. This resource provides information on diagnosing and managing Arrest of Dilation during labor, including common causes, risk factors, and treatment options. Learn about appropriate ICD-10 codes and best practices for healthcare professionals dealing with prolonged labor and Failure to Progress. Improve your understanding of Arrest of Dilation and ensure proper documentation for optimal patient care.
Also known as
Secondary arrest of labor
Labor has begun but dilation of the cervix has stopped progressing.
Prolonged first stage of labor
Abnormally long duration of the first stage of labor.
Failed induction of labor
Attempts to medically induce labor have been unsuccessful.
Prolonged second stage of labor
Abnormally long time between full dilation and delivery.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the cervix dilated 4-5cm or more?
Yes
Are uterine contractions inadequate?
No
Review documentation. Arrest of dilation typically occurs at 4-5cm or greater. If less than 4cm, consider prolonged latent phase (O62.2) or other diagnoses.
When to use each related code
| Description |
|---|
| Cervical dilation stops during active labor. |
| Slowed cervical dilation in active labor. |
| Difficult labor due to large fetal head or small maternal pelvis. |
Confusing prolonged labor with arrest of dilation can lead to inaccurate coding and reimbursement issues. CDI crucial for distinction.
Failing to specify the stage of labor (first stage) when coding arrest of dilation can result in claim denials. ICD-10 specificity required.
Lack of clear documentation of cervical dilation progress and other criteria can lead to coding errors and compliance risks. Physician queries needed.
Q: How to differentiate between protracted active phase of labor vs. arrest of dilation, and what are the appropriate management strategies for each?
A: Differentiating between protracted active phase of labor and arrest of dilation is crucial for appropriate management. Protracted active phase is diagnosed when cervical dilation proceeds slower than expected (e.g., <1cm/2hr in nulliparous, <1cm/hr in multiparous), but continues to progress. Management involves continued observation, support, and potential amniotomy if membranes are intact. Arrest of dilation, however, signifies a complete cessation of cervical change for 2 hours or more despite adequate uterine contractions. This necessitates a thorough evaluation, including assessment of fetal position, pelvic adequacy, and uterine activity. Management may involve augmentation with oxytocin or, if cephalopelvic disproportion is suspected or other interventions are unsuccessful, cesarean delivery. Explore how different fetal presentations can contribute to both protracted and arrested labor.
Q: What are evidence-based criteria for diagnosing arrest of dilation during labor, considering both nulliparous and multiparous women?
A: Diagnosing arrest of dilation requires careful consideration of parity and uterine activity. In nulliparous women, arrest of dilation is diagnosed when cervical dilation ceases for 2 hours or more despite adequate uterine contractions (generally defined as 200 Montevideo units in a 10-minute period). For multiparous women, the criteria are similar, but the duration may be shortened to 1 hour of arrested progress with adequate contractions. It's essential to confirm that the patient truly is in the active phase (at least 6cm dilated) before diagnosing arrest. It's equally important to ensure contractions are adequate, as hypotonic uterine activity can mimic arrest of dilation. Consider implementing standardized protocols for assessing uterine activity and cervical change to ensure consistent diagnosis. Learn more about the role of Friedman's curve in modern obstetric practice.
Patient presents with arrest of dilation, also known as arrested active phase of labor or failure to progress in active labor. Cervical dilation has ceased despite adequate uterine contractions for at least two hours in the active phase of labor, confirmed by digital cervical examination. Maternal vital signs remain stable. Fetal heart rate monitoring demonstrates a reassuring Category I tracing. Patient reports ongoing painful contractions. Intrauterine pressure catheter (IUPC) data, if available, supports the diagnosis of adequate uterine activity. Differential diagnoses considered include cephalopelvic disproportion (CPD), malposition, and inadequate uterine activity. Management options discussed with the patient include expectant management with continued monitoring, amniotomy if membranes are intact, augmentation of labor with oxytocin, and potential cesarean delivery if no further progress is observed or if fetal status becomes non-reassuring. Risks and benefits of each option were explained, and the patient will be continuously reassessed for progress. The medical decision making complexity for this encounter is moderate given the potential for maternal and fetal complications. ICD-10 code O62.0 and CPT codes relevant to labor management and procedures performed, such as 59514, 59414, or 59622 (if applicable), will be used for billing and coding purposes. Documentation will be updated to reflect patient response to chosen intervention.