A Novel Partogram for Stages 1 and 2 of Labor Based on Fetal Head Station Measured by Ultrasound: A Prospective Multicenter Cohort Study

Abstract

Objective This study was aimed to describe continuous labor curves, including second stage, based on fetal head station. Study Design We performed a prospective multicenter cohort study. The inclusion criteria were women with singleton uncomplicated cephalic term pregnancies in labor, who delivered vaginally. We used a device that combines ultrasound imaging with position-tracking technology to monitor the head station noninvasively throughout labor. We collected data on demographics, labor parameters, and delivery and neonatal outcomes. Results A total of 613 women delivered vaginally, 327 (53.3%) were nulliparous, while 286 (46.7%) were multiparous. Time to delivery (TTD) diminished progressively with descent of the fetal head. When the head is engaged, the labor curve of multiparous women demonstrated a more prominent downward shift in curve as compared with nulliparous women. When comparing multipara and nullipara at engagement level, the median TTD was 1 and 1.62 hours, respectively. In 95% of women with unengaged head during the second stage, TTD of nulliparous and multiparous women were less than 3.8 and 3 hours, respectively. Conclusion While current labor curves end at full dilatation, the described curves were developed throughout stages 1 and 2 of labor. The TTD, according to the station curves, shows an acceleration of labor, once passed the engagement level, especially in multiparous women.

WHO next‐generation partograph: revolutionary steps towards individualised labour care

“…In addition, formal regular recording of important clinical parameters describing duration and frequency of uterine activity and the wellbeing of the woman and baby, remain. The Labour Care Guide remains a record of clinical rather than ultrasound‐based parameters 13 …”

“…The Labour Care Guide remains a record of clinical rather than ultrasound-based parameters. 13 What has changed and why?…”

Advancement in Partograph: WHO’s Labor Care Guide

“…The partograph and the LCG are tools used to enhance women-centered care, but they also have some points in common and distinctions. The fundamental and revolutionary aspect of the original "Philpott chart" was its graphical display of labor development in relation to women's cervical dilation and fall of presenting part of the fetus against time [27,28]. The LCG and modified WHO partograph share some of these characteristics.…”