PURPOSE: The purpose of this document is to define labor and labor arrest and provide recommendations for the management of dystocia in the first and second stage of labor and labor arrest.

TARGET POPULATION: Pregnant individuals in the first or second stage of labor.

METHODS: This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one maternal–fetal medicine subspecialist appointed by the ACOG Committee on Clinical Practice Guidelines– Obstetrics and two external subject matter experts. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements.

RECOMMENDATIONS: This Clinical Practice Guideline includes definitions of labor and labor arrest, along with recommendations for the management of dystocia in the first and second stages of labor and labor arrest. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.

目的：本文件的目的是定义分娩和产程停滞，并为第一和第二产程难产和产程停滞的管理提供建议。

目标人群：处于第一或第二产程的妊娠个体。

方法：本指南是使用先验方案与由ACOG临床实践指南委员会-产科指定的一名母体-胎儿医学亚专家和两名外部主题专家组成的写作团队联合制定的。ACOG医学图书馆员完成了Cochrane Library、Cochrane Collaboration Registry of Controlled Trials、EMBASE、PubMed和MEDLINE中主要文献的全面文献检索。由撰写团队根据标准化入选和排除标准对进入全文筛选阶段的研究进行评估。纳入的研究进行了质量评估，并应用改良的GRADE（推荐评估、开发和评价分级）循证-决策框架解释证据并将证据转化为推荐声明。

建议：本临床实践指南包括分娩和产程停滞的定义，以及第一和第二产程难产和产程停滞的处理建议。建议按强度和证据质量分类。当由于证据不足或不存在而无法给出正式建议时，纳入未分级的药物临床试验质量管理规范要点以提供指导。