Duration of active phase affects delivery mode and pregnancy outcomes
10.3760/cma.j.issn.1007-9408.2013.03.004
- VernacularTitle:活跃期时限对分娩方式和妊娠结局的影响
- Author:
Xiaowei ZHANG
;
Ke MA
;
Yue DONG
- Publication Type:Journal Article
- Keywords:
Labor,obstetric;
Cesarean section;
Delivery,obstetric;
Pregnancy outcome
- From:
Chinese Journal of Perinatal Medicine
2013;(3):148-152
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of duration of active phase on delivery mode and pregnancy outcome.Methods Data of 417 women with abnormal active phase identified from 1744 term-birth,singleton,cephalic presentation primiparas who had tried vaginal delivery in Peking University First Hospital from January 1,2009 to December 31,2009 were retrospectively studied.Effects of different durations of protracted active phase on pregnancy outcomes were compared between women with vaginal delivery or cesarean section by Chi square test.Results The incidence of protracted active phase was 23.9％ (417/1744); and the incidence of prolonged active phase was 2.9％ (50/1744).There were 205 cases of cesarean section and 212 cases of vaginal deliveries.The incidence of neonates hospitalization in Department of Pediatrics in vaginal delivery group with active phase ≥6 h was higher than that of those with active phase ＜6 h [20.6％ (26/126) vs 8.1％ (7/86),x2 =6.07,P＜0.05].The incidence of intrauterine infection in cesarean section group with active phase ＜6 h were higher than that of those with active phase ≥6 h [22.7％ (30/132) vs 6.8％(5/73),x2 =8.37,P＜0.01].In vaginal group with protracted active phase before 6 cm of cervical dilation,the incidences of postpartum hemorrhage (4.8％,9/186),maternal complications (3.8％,7/186) and neonates hospitalization (15.6％,29/186) were similar with those after 6 cm of cervical dilation [6.2％ (1/16),x2=0.12; 0.0％ (0/16),x2=0.01 and 12.5％ (2/16),x2=0.00; all P＞0.05] respectively.In cesarean delivery group with cervical dilation ≥6 cm,the incidence of neonates hospitalization was higher than that of those with cervical dilation ＜6 cm [60.0％ (6/10) vs 19.9％ (34/171),x2 =8.83,P＜0.05].There were no difference in maternal age,gestational age,body mass index at delivery,volume of postpartum hemorrhage and neonatal birth weight between women with cesarean section whose protracted active phase ≥4 h or ＜4 h when cervical dilation at 3 cm (P＞ 0.05 respectively).The incidence of neonates hospitalization was low in women whose indication of cesarean section was protracted active phase (11.2％,9/80),while it was high when protracted active phase complicated with intrauterine infection (42.1％,16/38).Conclusions Protracted active phase with cervical dilation less than 6 cm might not need active management if neither the mother nor the fetus is compromised.The infants born vaginally should be closely monitored if the active phase is over 6 h.
