Normal levels of active contraction area in spontaneous labour

Steer, Philip; Carter, M. C.; Beard, R. W.

doi:10.1111/j.1471-0528.1984.tb04755.x

Cited by 47 publications

(26 citation statements)

References 26 publications

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“…5 However, in another small study of a mixed group of spontaneously laboring women, both nulliparous and multiparous, proceeding to spontaneous vaginal, operative vaginal, or Cesarean delivery, there was no correlation between contraction frequency and cervical dilatation. 6 Thus, the relationship between uterine contraction pattern and progress of labor remains unclear. The uterine contraction pattern, both rate and regularity, can easily be measured non-invasively and may be a potentially useful marker of inefficient uterine action.…”

Section: Introductionmentioning

confidence: 99%

Uterine Contraction Pattern as a Predictor of the Mode of Delivery

Oppenheimer¹,

Bland²,

Dabrowski

et al. 2002

J Perinatol

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Section: Introductionmentioning

confidence: 99%

Uterine Contraction Pattern as a Predictor of the Mode of Delivery

Oppenheimer¹,

Bland²,

Dabrowski

et al. 2002

J Perinatol

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“…Reports have suggested a lower UAI in multiparous women of low parity than in primigravidas during spontaneous labor. 9,13 Our findings of similar uterine activity during the first stage of labor in primigravida and parity 1 patients who have had previous cesarean sections may reflect the need to achieve vaginal delivery to reduce pelvic tissue resistance.…”

Section: 11mentioning

confidence: 69%

“…Maternal and neonatal characteristics are summarized in Table 1. Following spontaneous rupture of membranes or amniotomy, an intrauterine catheter-tipped pressure transducer was inserted as described by Steer et al 9 Uterine activity was recorded throughout the first stage of labor. The monitor also recorded the fetal heart rate from a scalp electrode.…”

Section: Methodsmentioning

confidence: 99%

“…Measurement of uterine activity is best correlated with cervical dilatation 9 and slow labor requiring oxytocin stimulation. 12 These factors make the use of an intrauterine catheter for measuring UAI in labor imperative in women who have had previous cesarean section.…”

Section: 11mentioning

confidence: 99%

“…[5][6][7] The active contraction area recorded is the integral of pressure above baseline tone with time (uterine activity integral [UAI] expressed in SI units as kilopascal seconds) is the most important single variable determining the rate of cervical dilatation. 8,9 This study reports the values of UAI during spontaneous unaugmented labor in women who have had previous cesarean section. …”

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confidence: 99%

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Characteristics of Uterine Activity During Labor After Previous Cesarean Section

Akiel

1988

Ann Saudi Med

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Uterine activity was studied during labor in 36 women who had previous cesarean sections. There was no difference in uterine activity between those delivered vaginally (66%) or those who needed repeat cesarean section, in overall values or at different cervical dilatations. Measurement of intrauterine pressure and electronic fetal monitoring helped reduce the need for repeat cesarean sections. Section. 1988; 8(3): 198-201 MeSH KEYWORDS: Cesarean section; Labor; Uterine contraction AS Akiel, Characteristics of Uterine Activity During Labor After Previous CesareanIn recent years the cesarean section rate has increased to between 15% and 18.3% of all deliveries in the United States, 1,2 and 23% to 33% 2,3 of these were in patients who had had previous cesarean section. In Ireland, O'Driscoll and Foley 4 reported a 4.3% cesarean section rate, about one quarter of which were due to repeat cesarean section. The advantages of electing repeat cesarean section are small family size, the ability to make advance arrangements for home assistance, and most importantly, a competent hospital team to reduce morbidity and mortality associated with operative deliveries. Sometimes, the expectant mothers are reluctant to accept repeat sections especially for nonrecurring causes. These women require adequate antenatal and intrapartum care, with particular attention to monitoring the scar from previous cesarean section. Antenatal evaluation in patients who have had previous cesarean delivery includes clinical and ultrasound assessment of the pregnancy and fetus, as well as radiologic examination of the pelvis. Careful intrapartum monitoring of maternal and fetal well-being is critical to prevent disastrous consequences.Measurement of intrauterine pressure (uterine activity) is the most reliable method of quantitating uterine work in labor. [5][6][7] The active contraction area recorded is the integral of pressure above baseline tone with time (uterine activity integral [UAI] expressed in SI units as kilopascal seconds) is the most important single variable determining the rate of cervical dilatation. 8,9 This study reports the values of UAI during spontaneous unaugmented labor in women who have had previous cesarean section. Patients and MethodsA prospective study was conducted on 36 women of Arabic origin in spontaneous labor who were delivered by cesarean section in their immediately previous pregnancy. The decision to attempt a trial of the cesarean scar was made by the obstetrician in charge of the patient prior to admission. Patients were considered to be suitable for a trial of the cesarean scar if pregnancy had been uncomplicated, presentation was cephalic, pelvimetry was adequate on clinical assessment (the anteroposterior diameter of the pelvic inlet more than 10 cm on erect lateral X-ray pelvimetry), and fetal weight was average clinically and by ultrasound (fetal weight assessment using abdominal

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Clinical assessment of uterine contractions

Cohen

2017

Intl J Gynecology & Obste

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The assessment of uterine contractions is important in clinical decision-making, but the precise role for appraising contractions remains controversial. Four clinical approaches to assessing contractions are available: manual palpation; intrauterine pressure determination; external tocodynamometry; and electrohysterography. Palpation is inexpensive and harmless but requires the constant bedside presence of a trained observer. Intrauterine pressure measurement is considered the most sensitive and specific technique, and has become the standard by which other methods are judged; however, its quantitative measurements are not always precise or reproducible. Moreover, the availability of intrauterine pressure measurements does not seem to improve maternal or neonatal outcomes in most situations. External tocodynamometry is the most widely used technique. It is easy to apply and provides reasonably accurate information about the frequency and duration of contractions, but not their amplitude. It can require frequent adjustment during labor and might not work well in patients who are obese. Electrohysterography is a recently available noninvasive technology that detects uterine electrical activity using electrodes placed on the mother's abdominal wall. This approach is at least as reliable and accurate as tocodynamometry.

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Normal levels of active contraction area in spontaneous labour

Cited by 47 publications

References 26 publications

Uterine Contraction Pattern as a Predictor of the Mode of Delivery

Uterine Contraction Pattern as a Predictor of the Mode of Delivery

Characteristics of Uterine Activity During Labor After Previous Cesarean Section

Clinical assessment of uterine contractions

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