Document Detail


Partogram action line study: a randomised trial.
MedLine Citation:
PMID:  9763048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the effect of three different partograms on caesarean section and maternal satisfaction. DESIGN: Prospective randomised clinical trial. SETTING: Regional teaching hospital in North West of England. PARTICIPANTS: Nine hundred and twenty-eight primigravid women with uncomplicated pregnancies who presented in spontaneous labour at term. INTERVENTIONS: The women were randomised to have their progress of labour recorded on a partogram with an action line 2, 3 or 4 hours to the right of the alert line. If the progress reached the action line, a diagnosis of prolonged labour was made. Prolonged labour was managed according to the standard ward protocol. MAIN OUTCOME MEASURES: Primary: Caesarean section rate and maternal satisfaction; secondary: need for augmentation, duration of labour, analgesia, cord blood gas analysis, postpartum haemorrhage, number of vaginal examinations, Apgar score and admission to special care baby unit. RESULTS: Caesarean section rate was lowest when labour was managed using a partogram with a 4-hour action line. The difference between the 3- and 4-hour partograms was statistically significant (OR 1 8, 95% CI 1.1-3.2), but the difference between 2 and 4 hours was not (OR 1.4, 95% CI 0.8-2.4). The women in the 2-hour arm were more satisfied with their labour when compared to the women in the 3-hour (P < 00001) and 4-hour (P <00001) arm. CONCLUSION: Our data suggest that women prefer active management of labour. It is possible that partograms which favour earlier intervention are associated with higher caesarean section rate. As the evidence on which to base the choice of partograms remains inconclusive further research is required.
Authors:
T Lavender; Z Alfirevic; S Walkinshaw
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  105     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-11-05     Completed Date:  1998-11-05     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  976-80     Citation Subset:  AIM; IM    
Affiliation:
Liverpool Women's Hospital, UK.
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MeSH Terms
Descriptor/Qualifier:
Cesarean Section / statistics & numerical data*
Female
Humans
Medical Records*
Obstetric Labor Complications / therapy
Patient Satisfaction
Pregnancy
Prospective Studies
Trial of Labor*

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


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