Cheyne et al developed an algorithm to aid midwives in making the diagnosis of active labor. The authors are from the University of Stirling, University of York, University of Aberdeen and Kings Cross Hospital (Dundee) in the United Kingdom.
The diagnosis of active labor was made by the presence of contractions that are:
(1) painful
(2) moderate to strong in intensity
(3) occurring at regular intervals
(4) accompanied by one or more of the following:
(4a) cervical effacement with dilatation >= 3 cm
(4b) spontaneous rupture of membranes
(4c) bloody show (blood-tinged mucus coming from a dilated cervical os)
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