Women's labour experiences and quality of care in relation to a prolonged latent phase of labour

Ängeby, Karin; Sandin‐Bojö, Ann‐Kristin; Persenius, Mona; Wilde‐Larsson, Bodil

doi:10.1016/j.midw.2019.07.006

Cited by 11 publications

(5 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, a Malaysian study on induction of labor demonstrated that maternal satisfaction is associated with a shorter interval between induction and delivery (23). A recent study also reported that women's perception of the healthcare quality, childbirth experience and feelings were associated with the latent phase duration (24).…”

Section: Discussionmentioning

confidence: 99%

Active Management of Labor Versus Expectant Management of Primiparous Women With a Prolonged Latent Phase: A Randomized Trial

Derbel,

Bardaa,

Chaker

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction: The duration of the latent phase of labour is variable and can reach 20 hours. According to the World Health Organization (WHO), a prolonged latent phase is the absence of cervical dilation beyond four centimeters after eight hours of regular uterine contractions. In this situation, women are at higher risk of medical interventions with a higher rate of emergency caesarean sections. There is no consensus regarding the management of prolonged latent phase. Thus, two attitudes are possible: Expectant management with spontaneous labour and active management with amniotomy and oxytocin infusion. The aim of our study was to compare the outcomes of expectant management to those of active management strategy in case of prolonged latent phase. Patients and methods: We undertook a prospective experimental randomized clinical trial, in the gynecology and obstetrics department of the university hospital Hédi Chaker, Sfax, Tunisia, between July 1st 2021 and December 31 2021. We included in our study primiparous women with spontaneous labor beginning and with prolonged latent phase. Only single evolutive pregnancy with cephalic presentation were included. Patients were randomized into two groups. For Active Management Group (AMG), the intervention was amniotomy followed by an oxytocin influsion. For the expectant management group (EMG), amniotomy and oxytocin infusion were not performed unless indicated. The primary outcome was the rate of cesarean sections. Results: Our study population consisted of 340 primiparous parturients with spontaneous labor beginning and with a prolonged latent phase. The caesarean section rate was 27.6% for the EMG versus 43.5% for the AMG (p < 0.001). Immediate complications were found in 18.2% of patients for the AMG versus 2.9% for the EMG (p < 0.001). The most common complication was postpartum hemorrhage (PPH) and was more frequent for AMG (12.4%). At birth, 93.5% of newborns for the EMG had an Apgar score between 8 and 10 versus 84.7% for the AMG (p = 0.01). Medical reanimation was required for 25 newborns after AMG and for 10 cases with EMG (p = 0.01). Five newborns for EMG (2.9%) and 15 newborns for GPA (8.8%) were admitted to the neonatal intensive care unit (p = 0.03).The average time between operation and vaginal delivery was longer for the EMG (15 hours and 47min versus 8 hours, p = 0.001). The mean duration of the latency phase in our study was 20 hours 38min for the EMG versus 13h and 19min for the AMG (p < 0.001). The average duration of the active phase was 5 hours 14min for the EMG versus 3 hours and 58min for the AMG (p < 0.001). Concerning the satisfaction of the parturients, 68.2% for the AMG were satisfied with the delivery process versus 82.4% for the EMG; p = 0.003. For immediate postpartum satisfaction, the majority of patients were very satisfied with no significant difference. Conclusion: The active attitude compared to the expectant attitude has shown several disadvantages: it gives more caesarean section rate, more maternal complications, less safety for the newborn, a longer hospital stay with less satisfied parturients. At the end of this study, and in the light of the results found in the literature, expectant management to manage the prolonged latency phase seems to be an effective alternative and we suggest its generalization.

show abstract

Section: Discussionmentioning

confidence: 99%

Active Management of Labor Versus Expectant Management of Primiparous Women With a Prolonged Latent Phase: A Randomized Trial

Derbel,

Bardaa,

Chaker

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…None of the categories was included in the medical-technical competence domain in the present study. This can be discussed about research showing that birthing women have high trust in receiving professional medical care 18 , 37 . Women value a birthing environment that lets them use their inherent physical and psychosocial capacities and want to give birth to a healthy baby in a safe environment that provides reassurance and technical competency 38 .…”

Section: Discussionmentioning

confidence: 99%

“…The study was conducted using a qualitative design based on free-text comments. The data originated from a major research project in which women’s experiences of early labor and quality of care were examined 18 , 19 . The questionnaires used in the present study were Intrapartal Quality from the Patient’s Perspective (QPP-I) 13 and the ELEQ.…”

Section: Methodsmentioning

confidence: 99%

Women's experiences and needs concerning care and support during the various phases of childbirth and postnatal period: Analysis of free-text comments based on Quality from the Patient’s Perspective in Sweden

Ängeby,

Ternström

2024

Eur J Midwifery

Self Cite

View full text Add to dashboard Cite

INTRODUCTION Positive birth experiences can be a decisive factor in the well-being and future health of both women and their newborns. The quality of care is a multidimensional concept influenced by the external structure of the organization, the administrative qualities of the environment, and the individual patient’s preferences about care. The aim was to describe women’s preferences and experiences concerning support and treatment, and their perception of quality of care during all phases of labor and the postnatal period. METHODS Free-text comments of 635 women from four different open comment questions were analyzed. A qualitative content analysis was conducted in two steps: an inductive phase followed by a deductive phase using the Quality of care from a Patient’s Perspective framework (QPP). RESULTS A total of 1148 free-text comments were coded; and 10 sub-categories were created and inserted under the QPP framework covering the latent meaning of the sub-category. Five of the sub-categories were sorted under the identity-oriented approach, four under physical-technical conditions, and one under the sociocultural atmosphere and reflected the women’s experiences and needs regarding support and treatment during early labor, the active phase of labor, and the postnatal period. CONCLUSIONS High-quality care and support are important aspects for women during childbirth, irrespective of the phase of labor or postnatal period. The need for individualized care, active participation in one’s own birth and using a family centered approach were also emphasized. Organizational factors influenced the quality of care and were particularly noticeable during birth.

show abstract

“…A study from our centre on the labour induction of nulliparas at term with unfavorable cervixes demonstrated that maternal satisfaction is associated with a shorter induction-to-delivery interval [24]. A very recent study also found that women’s perception of quality of intrapartum care, the birth experience and feelings were related to length of the latent phase of labour [25]. In this trial, despite significantly shorter intervention to delivery (both components of intervention to active labor and active labor to delivery intervals being significantly shorter when considered separately), women assigned to labor induction were not significantly more satisfied with their allocated intervention assessed to delivery and on baby outcome; indeed the point maternal satisfaction point estimates to delivery and on baby outcome non-significantly favored the expectant management arm.…”

Section: Discussionmentioning

confidence: 99%

Induction of labor compared to expectant management in term nulliparas with a latent phase of labor of more than 8 hours: a randomized trial

Sargunam

Bak

Tan

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundProlonged latent phase of labor is associated with adverse maternal and neonatal outcomes. Preliminary data indicate that labor induction for prolonged latent phase may reduce cesarean delivery. We performed a study powered to Cesarean delivery to evaluate labor induction compared to expectant management in full term nulliparas hospitalized for persistent contractions but non-progressive to established labor after an overnight stay.MethodsFrom 2015 and 2017, nulliparas, ≥ 39 weeks’ gestation with prolonged latent phase of labor (persistent contractions after overnight hospitalization > 8 h), cervical dilation ≤3 cm, intact membranes and reassuring cardiotocogram were recruited. Participants were randomized to immediate induction of labor (with vaginal dinoprostone or amniotomy or oxytocin as appropriate) or expectant management (await labor for at least 24 h unless indicated intervention as directed by care provider). Primary outcome measure was Cesarean delivery.ResultsThree hundred eighteen women were randomized (159 to each arm). Data from 308 participants were analyzed. Cesarean delivery rate was 24.2% (36/149) vs. 23.3%, (37/159) RR 1.0 95% CI 0.7–1.6; P = 0.96 in induction of labor vs. expectant arms. Interval from intervention to delivery was 17.1 ± 9.9 vs. 40.1 ± 19.8 h; P < 0.001, intervention to active labor 9.6 ± 10.2 vs. 29.6 ± 18.5 h; P < 0.001, active labor to delivery 7.6 ± 3.6 vs. 10.5 ± 7.2 h; P < 0.001, intervention to hospital discharge 2.4 ± 1.2 vs. 2.9 ± 1.4 days; P < 0.001 and dinoprostone use was 19.5% (29/149) vs. 8.2% (13/159) RR 2.4 95% CI 1.3–4.4; P = 0.01 in IOL compared with expectant arms respectively. Intrapartum oxytocin use, epidural analgesia and uterine hyperstimulation syndrome, postpartum hemorrhage, patient satisfaction on allocated intervention, during labor and delivery and baby outcome were not significantly different across trial arms.ConclusionsInduction of labor did not reduce Cesarean delivery rates but intervention to delivery and to hospital discharge durations are shorter. Patient satisfaction scores were similar. Induction of labor for prolonged latent phase of labor can be performed without apparent detriment to expedite delivery.Trial registrationRegistered in Malaysia National Medical Research Register (NMRR-15-16-23,886) on 6 January 2015 and the International Standard Randomised Controlled Trials Number registry, registration number ISRCTN14099170 on 5 Nov 2015.

show abstract

Women's labour experiences and quality of care in relation to a prolonged latent phase of labour

Cited by 11 publications

References 56 publications

Active Management of Labor Versus Expectant Management of Primiparous Women With a Prolonged Latent Phase: A Randomized Trial

Active Management of Labor Versus Expectant Management of Primiparous Women With a Prolonged Latent Phase: A Randomized Trial

Women's experiences and needs concerning care and support during the various phases of childbirth and postnatal period: Analysis of free-text comments based on Quality from the Patient’s Perspective in Sweden

Induction of labor compared to expectant management in term nulliparas with a latent phase of labor of more than 8 hours: a randomized trial

Contact Info

Product

Resources

About