Nivethitha Pitchaimuthu1, Shanta Bhaskaran1. 1. Department of Obstetrics and Gynaecology, Southern Railway HQ Hospital, Chennai, Constable Road, Perambur, Aynavaram, Chennai, Tamilnadu 600023 India.
Abstract
OBJECTIVES: In this study, we tried to make the customized labor curve by studying the labor pattern among the primigravidas and we compared the cervicograph with Zhang's and Suzuki's curves. This study may be a motivator for future research to create own labor norms for our Indian population which may help in reducing the cesarean section rates, principally in primigravidas. MATERIALS AND METHODS: It was a prospective observational study, which included 156 primigravidas with uncomplicated term singleton pregnancy with spontaneous onset and progression of labor, who had normal vaginal delivery with good maternal and neonatal outcome. RESULTS: The shape of the labor curve of this study was similar to Zhang' and Suzuki-Horiuchi's curves which had slower progression. The active phase started from 5 to 6 cm of cervical dilatation onwards which was similar to Suzuki-Horiuchi's curve. In the present study, the mean rate of cervical dilatation in the active phase was 1.5 cm/hour in contrast to Friedman's study which had a mean rate of cervical dilatation of 3 cm/hour with lower limit of 1.2 cm/hour as 5th centile. CONCLUSION: In the present study the mean rate of cervical dilatation in active phase in Indian women was approximately equivalent to the lowest acceptable rate of cervical dilatation in Friedman's study. If we continued to follow Friedman's labor norms, it could result in increasing c-sections. Hence, it would be prudent to create a customized labor curve for the local population served based on their individual characteristics features.
OBJECTIVES: In this study, we tried to make the customized labor curve by studying the labor pattern among the primigravidas and we compared the cervicograph with Zhang's and Suzuki's curves. This study may be a motivator for future research to create own labor norms for our Indian population which may help in reducing the cesarean section rates, principally in primigravidas. MATERIALS AND METHODS: It was a prospective observational study, which included 156 primigravidas with uncomplicated term singleton pregnancy with spontaneous onset and progression of labor, who had normal vaginal delivery with good maternal and neonatal outcome. RESULTS: The shape of the labor curve of this study was similar to Zhang' and Suzuki-Horiuchi's curves which had slower progression. The active phase started from 5 to 6 cm of cervical dilatation onwards which was similar to Suzuki-Horiuchi's curve. In the present study, the mean rate of cervical dilatation in the active phase was 1.5 cm/hour in contrast to Friedman's study which had a mean rate of cervical dilatation of 3 cm/hour with lower limit of 1.2 cm/hour as 5th centile. CONCLUSION: In the present study the mean rate of cervical dilatation in active phase in Indian women was approximately equivalent to the lowest acceptable rate of cervical dilatation in Friedman's study. If we continued to follow Friedman's labor norms, it could result in increasing c-sections. Hence, it would be prudent to create a customized labor curve for the local population served based on their individual characteristics features.
Entities:
Keywords:
Cervicograph; Customized labor curve; Labor pattern Indian study; Labor pattern in primigravidas; Spontaneous labor
Authors: Jun Zhang; Helain J Landy; D Ware Branch; Ronald Burkman; Shoshana Haberman; Kimberly D Gregory; Christos G Hatjis; Mildred M Ramirez; Jennifer L Bailit; Victor H Gonzalez-Quintero; Judith U Hibbard; Matthew K Hoffman; Michelle Kominiarek; Lee A Learman; Paul Van Veldhuisen; James Troendle; Uma M Reddy Journal: Obstet Gynecol Date: 2010-12 Impact factor: 7.661
Authors: Jeremy L Neal; Nancy K Lowe; Karen L Ahijevych; Thelma E Patrick; Lori A Cabbage; Elizabeth J Corwin Journal: J Midwifery Womens Health Date: 2010 Jul-Aug Impact factor: 2.388
Authors: Jeremy L Neal; Jane M Lamp; Jacalyn S Buck; Nancy K Lowe; Shannon L Gillespie; Sharon L Ryan Journal: J Midwifery Womens Health Date: 2014-02-11 Impact factor: 2.388