ACTIVE MANAGEMENT
OF LABOUR
What is the active management
of labour?
Br J
Obstet Gynaecol. 1998 Sep;105(9):976-80.
Partogram action line study: a randomised
trial.
Liverpool Women's Hospital, UK.
Objectives:
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.
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What is the active management of labour?
Br J
Obstet Gynaecol. 1998 Sep;105(9):976-80. Partogram action line study: a randomised
trial.
Liverpool Women's Hospital, UK. To assess the effect of three different
partograms on caesarean section and maternal satisfaction. Prospective randomised clinical trial. Regional teaching hospital
in North West of England.Objectives:
Design:
Setting:
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.
Your Own Web Presence
For £35
Have your own web ad on the internet and optimized for good positioning.
Your Own Dedicated Web Page Designed Specifically For You
More Effective
Than Your Own
Single Page Website
For £35