Progression of the first stage of spontaneous labour

Ábalos, Edgardo; Chamillard, Mónica; Díaz, Virginia; Pasquale, Julia; Souza, João Paulo

doi:10.1016/j.bpobgyn.2020.03.001

“…4 Following the update of its global recommendations on intrapartum care in 2018, 5 the WHO initiated a process to revise the partograph in light of recent evidence, including a new understanding of the individual variability of the progress of labours resulting in good perinatal outcomes, and the fact that many women do not experience a labour that conforms to the average rate on which the partograph design was based. 6,7 A large study and corresponding systematic reviews published in this journal [8][9][10] and subsequent analysis 11 failed to find evidence to support the use of a cervical dilatation rate of 1 cm/hour as a screening tool to predict adverse labour outcomes. The new WHO recommendations based on the emerging evidence on normal labour progression, as well as recommendations informed by the global shift towards improving experience of childbirth, 5 necessitated the design of a new labour monitoring tool called the WHO Labour Care Guide (Figure 1).…”

mentioning

confidence: 99%

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

Hofmeyr

¹

,

Bernitz

²

,

Bonet

³

et al. 2021

BJOG

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“…It took a median of 667 min for multiparous women to complete the delivery, which was noticeably faster than nulliparous women. Parity has proved to be the main contributing factor for the DT [12], and the DT can be obviously decreased in multiparous women compared with nulliparous women [13,14]. In the study by Stephanie A et al, the dilation time from 6-10 cm was 3.28 hours in nulliparous women, which was signi cantly slower than that of 2.03 hours in multiparous women [15].…”

Section: Discussionmentioning

confidence: 96%

A model to predict delivery time by induction of labour at term with a dinoprostone vaginal insert：A retrospective study

Huang

¹

,

Chen

²

,

Wu

³

et al. 2022

Preprint

0

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Background: Dinoprostone vaginal insert is the most common pharmacological method of induction of labour for pregnant women. Few studies have predicted the vaginal delivery time (DT), our study aimed to analyse the primary factors for DT among women at or beyond term who underwent labour induction with dinoprostone vaginal inserts in the middle of China. Methods: In this retrospective observational study performed in the obstetric ward in Zhongnan Hospital of Wuhan University, we ultimately included all women at37 weeks 0 days to 41 weeks 6 days of gestation who underwent labour induction with vaginal dinoprostone between January 1st, 2019, and December 31st, 2021. The primary outcome was vaginal or caesarean delivery; the principal secondary outcome was influence for DT including several maternal complications and neonatal characteristics. Results: A total of 1,562 women at or beyond term underwent labour induction, and 71% (1109/1562) delivered vaginally. The median delivery time (DT) was 740.50 min, with an interquartile range from 443.25 to 1264.50 min. A total of 29% (453/1562) of the women gave birth by caesarean section, and 11.9% (54/453) were multiparous. Multiple linear regression analysis showed that multiparity, advanced maternal age, foetal macrosomia, premature rupture of membranes (PROM), and having dinoprostone inserted during the day all significantly influenced DT. A mathematical model was developed to integrate these factors for predicting DT: Y=804.478–125.284 × multiparity + 765.637 × advanced maternal age + 411.511 × foetalmacrosomia-593.358 × dinoprostone inserted during the day - 125.284×PROM. Conclusions: The DT with dinoprostone vaginal inserts was increased in women with advanced maternal age and foetal macrosomia, but decreased in multiparity, PROM, and dinoprostone inserted during the day.This study allows obstetricians to calculate a preliminary DT for pregnant women before placing a dinoprostone insert, which may be helpful to improve the management of patients and reduce the risk in busy maternity wards.

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“…With rich practical care experience and useful prediction data, the discussion of the contextualized discussions of shared decision-making in what is most meaningful to women is more specific and accurate, and the decision errors caused by the differences in dystocia methods are minimized [ 7 ]. In addition, many high-income countries (HICs) and more low- and middle-income countries (LMICs) are undergoing “obstetric transition” [ 8 , 9 ]. This is a concept regarding the long-term trend of declining fertility and maternal mortality.…”

Section: Discussionmentioning

confidence: 99%

Manipulative Reduction for Abnormal Uterine Inclination in Vaginal Delivery

Chen

¹

,

Yuan

²

,

Wang

³

2022

Computational and Mathematical Methods in Medicine

0

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Objective. To investigate the manipulative reduction in abnormal uterine inclination in vaginal delivery. Methods. With the independently developed uterine inclination surveyor, 40 primiparas with abnormal uterine inclination were randomly divided into two groups: treatment group (Group A, 20 cases) and control group (Group B, 20 cases). The general condition of the primipara, the labor stages, the changes in uterine inclination after treatment, postpartum hemorrhage at 2 hours, and the general condition of fetuses were observed to study the therapeutic value of manual reduction in abnormal uterine inclination. Result. In the control group, one uterine inclination was not corrected with the change in labor process, and the pregnancy was terminated due to stagnation of the active phase. In the first stage of labor, the time spent in the treatment group ( 393.4 ± 31.3 mins) was significantly lower than that in the control group ( 440.7 ± 34.9 mins) ( P = 0.001 ). Compared with the control group ( 49.8 ± 6.5 mins), the treatment group ( 42.6 ± 7.2 mins) also exhibited a significantly shortened second stage of labor ( P = 0.02 ). Sixteen cases (16/20) in the treatment group returned to normal after manual reduction, and 9 cases (9/20) in the control group returned to normal with the progression of natural labor. Manual reduction could be used as an option to treat abnormal uterine inclination ( P = 0.01 ). There was no significant difference in the third stage of labor ( P = 0.2 ), 2-hour postpartum hemorrhage ( P = 0.35 ), Apgar score ( P = 0.64 ), or body weight ( P = 0.76 ) between the two groups. Conclusion. Manual reduction in the treatment of abnormal uterine inclination has obvious effects, shortens the birth process, and is safe for the fetus.

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Progression of the first stage of spontaneous labour

Cited by 16 publications

References 33 publications

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

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

A model to predict delivery time by induction of labour at term with a dinoprostone vaginal insert：A retrospective study

Manipulative Reduction for Abnormal Uterine Inclination in Vaginal Delivery

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