made an important contribution to this debate when he rigorously assessed the accuracy of station diagnosis with digital examinations. Recent studies, however, dispute these findings and found clinical examination of fetal descent and position to be subjective with high interobserver variation. In one study from the 1980s, repeatability of digital examinations was found to be acceptable. Traditionally, labor progression has been assessed by digital examination of cervical dilatation and fetal descent. Prolonged labor is defined when cervical dilatation crosses the “action line.” Some hospitals use partographs from the Dublin school of “active management of labor” and expect one-cm dilatation/hour (the slope of the alert line), whereas other hospitals define prolonged labor when cervical dilatation is <1.2 cm/h in nulliparous women and <1.5 cm/h in parous women. Philpott suggested in 1972 to use “alert lines” and “action lines” (4 h from the “alert line”) in partographs to evaluate labor progress, and WHO has adopted this method. He has documented a strong correlation between cervical dilatation and station and an association between high station at arrest of labor and adverse outcome. In 1954, Friedman introduced the partograph. Minus five corresponds to the pelvic inlet, zero to the level of the ischial spine, and plus four corresponds to the pelvic floor (Fig. The fetal descent in the birth canal is assessed by vaginal digital examinations and related to the ischial spine (Fig. Müller first described the concept of station in 1868. The fetal lie can be longitudinal or transverse, presentation describes the lowest fetal part in the birth canal, position means how the fetus is rotated, and station refers to the level of the presenting part in the birth canal.
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