Document Detail

Station at onset of active labor in nulliparous patients and risk of cesarean delivery.
MedLine Citation:
PMID:  10074972     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether term nulliparas with an unengaged vertex presentation at onset of active labor have a higher risk for cesarean delivery. METHODS: A retrospective cohort of 1250 randomly chosen nulliparous patients at 37-42 weeks' gestation who delivered between 1988 and 1989 were selected. Four hundred forty-seven patients were excluded because of nonvertex presentation, cesarean delivery before active phase of labor, multiple gestation, delivery at less than 37 weeks' or greater than 42 weeks' gestation, induction of labor, or missing charts. For the purpose of this study, active labor was defined as regular contractions with cervical dilatation of at least 3 cm. The station at onset of active labor was recorded. Engagement was considered to be at station 0 or below. RESULTS: Of the 803 patients in the study group, 567 presented unengaged and 236 patients presented engaged. The cesarean rates differed significantly between the two groups: 14% of those unengaged compared with 5% of those engaged (chi2 = 11.9, P < .001). After adjusting for confounding variables, engagement at the time of onset of active labor was associated with lower risk of cesarean delivery (odds ratio .512, 95% confidence interval .285, .922). CONCLUSION: Eighty-six percent of nulliparas with an unengaged vertex at onset of active labor delivered vaginally. Engaged vertex at the onset of active labor was associated with a lower risk of cesarean delivery.
D Roshanfekr; K J Blakemore; J Lee; N A Hueppchen; F R Witter
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  93     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-04-05     Completed Date:  1999-04-05     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  329-31     Citation Subset:  AIM; IM    
Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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MeSH Terms
Cesarean Section / statistics & numerical data*
Labor Stage, First*
Retrospective Studies
Risk Factors
Comment In:
Obstet Gynecol. 1999 Jul;94(1):161   [PMID:  10389744 ]

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