Comparison of effacement curve with dilatation curve for prediction of labor progression

Abstract

Aim: This study was conducted to evaluate the ability of the effacement curve to predict fetal descent by comparing it to dilatation in order to improve the accuracy of the current partogram. Method: We conducted an observational study of women who were admitted for vaginal delivery at Mobini Hospital, Sabzevar, Iran in 2015. During labor, dilatation and effacement were plotted in different graphs and then their association with fetal descent was separately evaluated and compared. This assessment was performed in two groups: primipara and multipara. Results: From 1750 individuals, 503 primiparous and 512 multiparous women were eligible for the study. An adjusted generalized estimating equations multivariable model showed both dilatation and effacement had a significant relationship with fetal descent either in primipara or multipara. In primipara, the prediction value of effacement equalled dilatation (β,eff 0.29, P < 0.001; β,dil 0.30, P < 0.001). In multipara, the prediction value of effacement was obviously higher than dilatation (β,eff 0.45, P < 0.001; β,dil 0.27, P < 0.001). The strength of effacement to predict labor in multipara was clearly greater than in primipara (β,eff 0.45 and β,eff 0.29, respectively). The strength of dilatation to predict labor in multipara was comparable to primipara (β,dil 0.27 and β,dil: 0.30, respectively). Conclusions: Regarding the acceptable predictive value of effacement, we believe considering effacement, dilatation and station curves altogether can improve the power of the existing partogram for the assessment of labor progression and detection of failure to progress.

Association of cervical effacement with spontaneous labour progression in low risk pregnant females

“…Labor is defined as "uterine contractions that bring about demonstrable effacement and dilation of the cervix." (10) While labor involves both dilation and effacement, existing labor curves demonstrate only the rate of cervical change in relationship to cervical dilation (1)(2)(3)(4). We sought to investigate how cervical effacement might influence expectations of the rate of cervical change.…”

“…Much attention has been paid to when the transition to active labor begins. The CSL data suggest that active labor may not begin until 6 cm (1,6) . This strict criterion, however, has been challenged by Cohen and Friedman who "discouraged the use of any specific degree of dilation for the identification of the active phase" (13) .…”

“…Recently, the Consortium on Safe Labor (CSL) labor curves have replaced the traditional labor curve proposed by Friedman (1)(2)(3)4) . The importance of understanding normal labor progression was highlighted by Rouse and colleagues in 1999 when they challenged the idea that arrest of labor could be diagnosed after only 2 hours of inadequate cervical change (5) .…”

Analysis of demographic characteristics affecting labour curve in low risk pregnant woman in tertiary care hospital in Central India

“…Last few decades had seen an increase in rate of caesarean delivery but without any decrease in maternal and neonatal morbidity or mortality rate 1,2 . One of most sited reason of caesarean delivery is abnormalities of labour progress followed by foetal heart rate abnormalities 3 Apart from the fact that caesarean delivery is detrimental to mother and newborn both, it has various other complications viz.…”