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Impact factors on fetal descent rates in the active phase of labor: a retrospective cohort study


Kimmich, Nina; Juhasova, Jana; Haslinger, Christian; Ochsenbein-Kölble, Nicole; Zimmermann, Roland (2017). Impact factors on fetal descent rates in the active phase of labor: a retrospective cohort study. Journal of Perinatal Medicine, 0(0):Epub ahead of print.

Abstract

Aim: To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors.
Methods: In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated.
Results: Fetal descent rates are exponentially increasing. Nulliparous women have slower fetal descent than multiparous women (P<0.001), ranging from 0 to 5.81 cm/h and from 0 to 15 cm/h, respectively. The total duration of fetal descent in labor is 5.42 h for nulliparous and 2.71 h for multiparous women. Accelerating impact factors are a lower fetal station, multiparity, increasing maternal weight and fetal occipitoanterior position, whereas epidural anesthesia decelerates fetal descent (P<0.001).
Conclusions: Fetal descent is a hyperbolic increasing process with faster descent in multiparous women compared to nulliparous women, is highly inter individual and is associated with different impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates as well as on individual evaluation of every parturient.

Abstract

Aim: To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors.
Methods: In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated.
Results: Fetal descent rates are exponentially increasing. Nulliparous women have slower fetal descent than multiparous women (P<0.001), ranging from 0 to 5.81 cm/h and from 0 to 15 cm/h, respectively. The total duration of fetal descent in labor is 5.42 h for nulliparous and 2.71 h for multiparous women. Accelerating impact factors are a lower fetal station, multiparity, increasing maternal weight and fetal occipitoanterior position, whereas epidural anesthesia decelerates fetal descent (P<0.001).
Conclusions: Fetal descent is a hyperbolic increasing process with faster descent in multiparous women compared to nulliparous women, is highly inter individual and is associated with different impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates as well as on individual evaluation of every parturient.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:25 July 2017
Deposited On:05 Jan 2018 08:20
Last Modified:24 Mar 2018 02:00
Publisher:De Gruyter
ISSN:0300-5577
OA Status:Closed
Publisher DOI:https://doi.org/10.1515/jpm-2017-0075
PubMed ID:28742525

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