If after 4 hours not progressed, then can to arm and oxytocin and wait another 2 hours. IF not imporved, then check wheher mother and fetus doing well. IF well can wait for another 2 hours while diagnosing why. If not then find out why. and if all okay then give one more hour. IF found out anything wrong at a any point must take action. if exhausted hours of waiting then diagnose obstructed labour and then take action. so 4 + 2 + 2 + 1
Must be able to diagnose whats happening based on the partogram!
Oxytocin augmentation not that necssarily if have good contractions. So can reassess menwhile check for other problems.
Vaccum delivery must be only done when cervix is fully dialated. and no cpd.