Predictive value of cervical dilatation rates. I. Primipara labor.

A modified version of Philpott's partogram was used to analyze primipara labor in Israel. The rate of cervical dilatation measure early in the active phase of labor (initial rate) is an accurate indicator of the outcome of labor. Ninety-three percent of primiparas with an initial cervical dilatation rate of 1.00 cm/hour or more delivered spontaneously. Seventy-six percent of those with an initial cervical dilatation rate of less than 1.00 cm/hour required an assisted delivery (forceps or vacuum) or cesarean section. The mean cervical dilatation rate for spontaneous deliveries as measured early in the active phase was 1.75 cm/hour. Patients needing an assisted delivery had a mean cervical dilatation rate of 0.93 cm/hour, and for cesarean section deliveries the mean rate was 0.42 cm/hour. No significant differences were observed among patients of different ethnic origins. The initial cervical dilatation rate proves to be useful in early identification of those patients who deliveries were complicated. The method avoids complicated cervicographs and is simple and reliable.