Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset

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Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset

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Publication Article, peer reviewed scientific
Title Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset
Author(s) Kjærgaard, Hanne ; Olsen, Jørn ; Ottesen, Bent ; Dykes, Anna-Karin
Date 2009
English abstract
Objective. To estimate the incidence of dystocia among nulliparous women without apparent co-morbidity and to examine maternal and fetal short-term outcomes after dystocia. Design. A multi-center cohort study with prospectively collected data. Setting. Nine obstetric departments with annual birth rates between 850 and 5,400. Population. Low-risk nulliparous women in term spontaneous labor with a singleton fetus in cephalic presentation. Methods. Follow-up of 2,810 nulliparas using self-administered questionnaires supplemented with clinical records. Criteria for dystocia. Cervical dilatation ≤2 cm over four hours during the first stage of labor or no descent during two hours (three hours with epidural analgesia) in the descending phase of second stage or no progress for one hour during the expulsive phase of the second stage. Inclusion took place between May 2004 and July 2005. Main outcome measures. Incidences of dystocia, maternal, and fetal outcomes. Results. The cumulative incidence of dystocia was 37% and of the diagnoses 61% were given in the second stage of labor. Women with dystocia treated by augmentation had more cesarean and ventouse deliveries, more often non-clear amniotic fluid, more post-partum hemorrhage and their children were more often given low one-minute neonatal Apgar scores as compared to women delivered without a diagnosis of dystocia. Conclusions. A dystocia incidence of 37% was found in healthy term nulliparas with no indication for induction or elective cesarean delivery. The adverse maternal and neonatal birth outcomes may be related to the cause of dystocia or to augmentation of labor and this question calls for further studies.
DOI http://dx.doi.org/10.1080/00016340902811001 (link to publisher's fulltext)
Host/Issue Acta Obstetricia et Gynecologica Scandinavica;4
Volume 88
ISSN 0001-6349
Pages 402-407
Language eng (iso)
Subject(s) dystocia
prolonged labor
nulliparas
incidence
augmentation
Medicine
Research Subject Categories::MEDICINE::Surgery::Obstetrics and women's diseases
Handle http://hdl.handle.net/2043/9969 (link to this page)

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