Document Detail

Comparison of active phase labor between triplet, twin, and singleton gestations.
MedLine Citation:
PMID:  11035282     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To characterize the active phase of labor in triplet pregnancies and compare it with gestational age-matched twins and singletons. METHODS: Active phase rates were calculated beginning at 5 cm of dilation for women with triplet gestations longer than 24 weeks who labored and reached the second stage. Twin and singleton cohorts that also completed the first stage of labor were matched for gestational age at delivery (+/-1 week), parity, and epidural use. Intrapartum variables included oxytocin use (induction or augmentation, duration of infusion, and maximum dosage), cervical dilation at membrane rupture, and active phase dilation rate. RESULTS: Thirty-two triplet pregnancies met inclusion criteria between January 1994 and September 1998 and were each compared with twin and singleton cases in a 1:2 ratio. Triplet and twin active phase rates, while similar (1.8 versus 1.7 cm/hour, respectively), were significantly lower than the mean singleton dilation rate (2.3 cm/hour, P =.02). No other intrapartum variables differed between the three groups. Despite controlling for gestational age at delivery, mean birth weights were significantly higher in singletons and correspondingly lower in twins and triplets (2,493 versus 2,112 and 1,968 g, respectively; P =.001). An analysis of active phase dilation rates as a function of the cumulative birth weight per pregnancy demonstrated an inverse correlation, with slower progress in active labor associated with increasing total fetal weight (R = -.24; P =.002). CONCLUSIONS: Triplet and twin active phase dilation proceeds at a slower rate than that observed in singleton pregnancies. The rate of active phase dilation is inversely correlated to total fetal weight.
R K Silver; E I Haney; W A Grobman; S N MacGregor; H L Casele; M G Neerhof
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the Society for Gynecologic Investigation     Volume:  7     ISSN:  1071-5576     ISO Abbreviation:  J. Soc. Gynecol. Investig.     Publication Date:    2000 Sep-Oct
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9433806     Medline TA:  J Soc Gynecol Investig     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  297-300     Citation Subset:  IM    
Division of Maternal-Fetal Medicine, Evanston & Prentice Womens' Hospitals, Northwestern University Medical School, Chicago, Illinois, USA.
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MeSH Terms
Birth Weight
Gestational Age
Labor, Obstetric / physiology*
Regression Analysis
Time Factors

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

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