Understanding Failure to Descend (FTD) or Failure to Progress (FTP) during labor? This resource provides essential information for healthcare professionals on the diagnosis, documentation, and medical coding of Arrest of Descent. Learn about clinical indicators, ICD-10 codes related to FTD and FTP, and best practices for accurate medical record keeping. Improve your clinical documentation and coding accuracy for labor complications including Failure to Descend and Arrest of Descent.
Also known as
Secondary arrest of labor, unspecified
Labor has stopped progressing after initially proceeding normally.
Arrest of descent of fetal head
The baby's head is not moving down the birth canal.
Other secondary arrest of labor
Other specified reasons for labor stopping after initial progress.
Secondary arrest of labor, unspecified
Labor has stopped progressing, reason not specified.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is this during labor?
Yes
Is the cervix fully dilated?
No
Is it fetal malposition?
When to use each related code
| Description |
|---|
| Labor stalled due to baby's position. |
| Slow, prolonged labor progression. |
| Difficult or obstructed labor. |
Using non-specific codes like F02.9 (Unspecified mental disorder) instead of precise labor/delivery codes like O62.X for obstructed labor.
Insufficient documentation differentiating failure to descend from other labor complications, leading to inaccurate code assignment (e.g., prolonged labor).
Overlooking and not coding contributing factors like cephalopelvic disproportion or fetal malpresentation alongside the failure to descend diagnosis.
Q: What are the best strategies for managing failure to descend in the second stage of labor when considering maternal and fetal well-being?
A: Managing failure to descend in the second stage of labor requires a careful assessment of both maternal and fetal well-being. Factors influencing management decisions include the duration of the second stage, maternal exhaustion, fetal position and station, and the presence of caput or molding. Options include expectant management with continued support and positional changes, operative vaginal delivery with forceps or vacuum, or cesarean delivery. When choosing a course of action, clinicians should prioritize minimizing maternal and fetal morbidity. Consider implementing standardized protocols for managing the second stage of labor to ensure consistent, evidence-based care. Explore how implementing a checklist for second-stage labor management can improve outcomes and reduce complications. Learn more about current ACOG guidelines for managing labor dystocia.
Q: How can I differentiate between protracted descent and arrest of descent during labor, and what factors should influence my clinical decision-making?
A: Differentiating between protracted descent and arrest of descent hinges on understanding the normal progression of labor and recognizing deviations from expected patterns. Protracted descent refers to a slower than expected rate of fetal descent, whereas arrest of descent signifies a complete cessation of progress. Diagnosis involves careful evaluation of the partograph, assessing cervical dilation and fetal station over time. Clinical decision-making requires considering risk factors such as maternal age, body mass index, fetal size, and pelvic adequacy. Furthermore, the presence of complications like fetal malposition or cephalopelvic disproportion influences management strategies. Consider incorporating continuous electronic fetal monitoring and regular vaginal examinations to accurately assess labor progress. Explore how using a standardized partograph can aid in early identification of labor abnormalities. Learn more about risk factors associated with dystocia and strategies for individualized patient care.
Patient presents with failure to descend, also known as failure to progress or arrest of descent, during labor. Cervical examination reveals adequate dilation but lack of fetal descent despite adequate uterine contractions. The patient's labor progress has stalled, meeting the criteria for cephalopelvic disproportion. Fetal monitoring demonstrates a reassuring fetal heart rate tracing. Maternal vital signs remain stable. Risk factors for failure to descend, including fetal malposition, macrosomia, and maternal pelvic anatomy, were assessed. Management options, including expectant management, oxytocin augmentation, and operative vaginal delivery or cesarean section, were discussed with the patient. Decision for continued monitoring with potential for cesarean delivery if no progress is observed within the next two hours. Diagnosis of failure to descend complicates this pregnancy and impacts medical billing and coding. This documentation supports ICD-10 code O62.1 and reflects current obstetric clinical practice guidelines.