Document Detail


Active-phase arrest in labor: predictors of cesarean delivery in a nulliparous population.
MedLine Citation:
PMID:  8469468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify clinical variables associated with cesarean delivery for active-phase arrest with hypotonic labor. METHODS: We reviewed all deliveries at our institution from September 1975 through March 1989. Data were collected from medical records and a computerized data base. Nulliparas with active-phase arrest were identified and those with hypotonic labor (defined as less than 180 Montevideo units) were selected. The clinical characteristics of each parturient were examined. A linear logistic regression analysis was used to examine the incidence of cesarean delivery as a function of clinical variables. RESULTS: The incidence of active-phase arrest was 4.9%, and hypotonic forces were diagnosed in 81% of the cases managed with an intrauterine pressure catheter. Despite the consistent use of oxytocin in hypotonic labor, the cesarean rate was 60%. Four factors correlated with cesarean delivery in this setting: estimated fetal weight, station at the time of arrest, duration of ruptured membranes, and year of delivery. CONCLUSIONS: After an active-phase arrest, cesarean delivery increased when there was suspected cephalopelvic disproportion. In addition, we observed a strong correlation between cesarean delivery and the year of delivery, which suggests a change in physician behavior over time, independent of all other risk factors for cesarean.
Authors:
V L Handa; R K Laros
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  81     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-05-13     Completed Date:  1993-05-13     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  758-63     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California School of Medicine, San Francisco.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / statistics & numerical data*
Cohort Studies
Female
Humans
Incidence
Labor Stage, First
Obstetric Labor Complications / epidemiology*
Parity*
Pregnancy
Regression Analysis
Risk Factors

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


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