Document Detail


Active management of labor: a meta-analysis of cesarean delivery rates for dystocia in nulliparas.
MedLine Citation:
PMID:  9267867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this article is to determine through meta-analysis of published literature whether active management of labor lowers the cesarean delivery rate for dystocia in nulliparas. Using MEDLINE and reference citations to 1966, 18 published reports in English on active management of labor were identified. Selection criteria for five selected studies included: tenets of active management followed, detailed description of patient selection and analysis, numerical data on cesarean deliveries for dystocia in nulliparas, and use of a control group. Data on cesarean deliveries performed on nulliparas for dystocia were abstracted onto 2 x 2 tables by both authors independently (one blinded to study authors, journal, institution, and conclusions), and quality ratings independently assessed. Differences were resolved by consensus. Individual odds ratios were calculated, with summary odds ratios and 95 percent confidence intervals determined using the Mantel-Haenszel method. Including the three highest quality studies (two randomized, one nonrandomized), there was a 34 percent decrease in cesarean delivery rates associated with active management (OR 0.66, 95 percent CI 0.54-0.81), without an increase in adverse neonatal outcome (OR for cesarean for non-reassuring fetal heart rate monitoring 0.91, 95 percent CI 0.68-1.22). Active management of labor is associated with a 34 percent decrease in the rate of cesarean delivery for dystocia in nulliparas. Along with the expected subsequent decrease in numbers of candidates for trials of labor, the decline in total cesarean deliveries over the entire population directly or indirectly attributable to active management is 13 percent.
Authors:
J C Glantz; T J McNanley
Related Documents :
3429607 - Head measurements in newborn infants.
18538157 - Nulliparous term singleton vertex cesarean delivery rates: institutional and individual...
9527937 - Does cesarean section decrease the incidence of major birth trauma?
6723437 - Evidence of spinal cord injury in an infant delivered by cesarean section. a case report.
7171497 - Characteristics and management of intrapartum prolonged fetal bradycardia.
24019227 - Jumping translocation in a case of de novo infant acute myeloid leukemia.
Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Obstetrical & gynecological survey     Volume:  52     ISSN:  0029-7828     ISO Abbreviation:  Obstet Gynecol Surv     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-10-02     Completed Date:  1997-10-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401007     Medline TA:  Obstet Gynecol Surv     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  497-505     Citation Subset:  IM    
Affiliation:
University of Rochester School of Medicine and Dentistry, Department of Obstetrics and Gynecology, New York, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cesarean Section / statistics & numerical data*
Delivery, Obstetric / methods*
Dystocia / prevention & control*,  surgery*
Evidence-Based Medicine
Female
Humans
Labor, Induced
Odds Ratio
Parity*
Pregnancy
Pregnancy Outcome
Research Design

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  In vivo characterization of Gd(BME-DTTA), a myocardial MRI contrast agent: tissue distribution of it...
Next Document:  Prenatal ultrasonographic morphologic assessment of the umbilical cord: a review. Part I.