Document Detail

Breech labor on the WHO partograph.
MedLine Citation:
PMID:  9749882     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To assess the impact of breech labor management using the WHO partograph on fetal and maternal outcomes of labor. METHOD: All 1,740 breech presentations in a larger multicenter hospital-based study in South East Asia of the use of the WHO partograph in labor management were studied. The partograph was introduced into each hospital during the study and a before and after analysis of various labor outcomes was conducted. RESULTS: There were 923 breech presentations prior to implementation of the partograph and 817 after. The overall Cesarean section rate was 29.7% (21.6% emergency and 7.6% elective). Introducing the partograph reduced Cesarean sections for multigravida from 27.1% to 19.3% (non-significant) but had no impact on the rate for primigravida (38.5% to 38.7%). Prolonged labor (> 18 hours) was reduced significantly among multigravida and primigravida (p < 0.05), despite a reduced use of oxytocin. Intrapartum stillbirths fell (non-significantly) from 1.9% to 1.1% (all parities combined). Fetal outcome, as measured by intrapartum deaths and Apgar scores < 7 at 1 minute, was significantly better (P < 0.05) when delivery was by Cesarean section rather than vaginally, regardless of use of the partograph. CONCLUSION: The use of the WHO partograph in the management of breech labor reduces prolonged labor and (among multigravida) Cesarean sections and improves fetal outcome. In this study, however, Cesarean section was a safer method of delivery for the baby, regardless of use of the partograph.
C E Lennox; B E Kwast; T M Farley
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  62     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-18     Completed Date:  1998-11-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  117-27     Citation Subset:  IM    
Law Hospital NHS Trust, Carluke, UK.
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MeSH Terms
Apgar Score
Breech Presentation*
Data Collection
Developing Countries
Fetal Monitoring / methods*
Pregnancy Outcome*
World Health Organization

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