Analysis of spontaneous labor progression of breech presentation at term.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
07
01
2021
accepted:
15
12
2021
entrez:
14
3
2022
pubmed:
15
3
2022
medline:
15
4
2022
Statut:
epublish
Résumé
Cervical dilatation curves are widely used to describe normal and abnormal labor progression for cephalic presentation. Labor curves for breech presentations have never been described. The aims of this study were to examine the pattern of labor progression in women with a breech presentation and to determine whether the type of breech or parity can influence the speed of cervical dilatation. We analyzed the labor data from 349 women with a term, singleton, and breech fetus after spontaneous onset of labor in 2010-2018. Cesarean deliveries were excluded. The patterns of labor progression were described by examining the relationship between the elapsed times from the full dilatation and cervical dilatation stages. Average labor curves were developed using repeated-measures analysis with 3rd degree polynomial modeling. The results were interpreted according to parity and the type of breech. The first stage of labor progression was divided into a latency phase from 0 to 5 cm of dilatation and an active phase from 5 to 10 cm. In the active phase, the median speed of cervical dilatation was 1.67 cm/h [1.25, 2.61] (2 cm/h for multipara and 1.54 cm/h for nullipara). The difference by parity was significant in the active phase (p< 0.05). The cervical dilatation rate from 3 cm to 10 cm did not significantly differ between the complete and frank breeches (1.56 cm/h vs 1.75 cm/h, p = 0.48). However, the median cervical dilatation rate from 8 cm to complete dilatation was faster for complete breeches (1.92 cm/h versus 1.33 cm/h, p = 0.045). As with cephalic presentation, the first stage of labor progression for breech presentation can be divided into a latent and active phase. Labor progression should be interpreted with respect to parity, and women should be informed that the type of breech does not seem to influence the cervical dilatation rate when there is adequate management.
Sections du résumé
BACKGROUND
Cervical dilatation curves are widely used to describe normal and abnormal labor progression for cephalic presentation. Labor curves for breech presentations have never been described.
OBJECTIVES
The aims of this study were to examine the pattern of labor progression in women with a breech presentation and to determine whether the type of breech or parity can influence the speed of cervical dilatation.
STUDY DESIGN
We analyzed the labor data from 349 women with a term, singleton, and breech fetus after spontaneous onset of labor in 2010-2018. Cesarean deliveries were excluded. The patterns of labor progression were described by examining the relationship between the elapsed times from the full dilatation and cervical dilatation stages. Average labor curves were developed using repeated-measures analysis with 3rd degree polynomial modeling. The results were interpreted according to parity and the type of breech.
RESULTS
The first stage of labor progression was divided into a latency phase from 0 to 5 cm of dilatation and an active phase from 5 to 10 cm. In the active phase, the median speed of cervical dilatation was 1.67 cm/h [1.25, 2.61] (2 cm/h for multipara and 1.54 cm/h for nullipara). The difference by parity was significant in the active phase (p< 0.05). The cervical dilatation rate from 3 cm to 10 cm did not significantly differ between the complete and frank breeches (1.56 cm/h vs 1.75 cm/h, p = 0.48). However, the median cervical dilatation rate from 8 cm to complete dilatation was faster for complete breeches (1.92 cm/h versus 1.33 cm/h, p = 0.045).
CONCLUSION
As with cephalic presentation, the first stage of labor progression for breech presentation can be divided into a latent and active phase. Labor progression should be interpreted with respect to parity, and women should be informed that the type of breech does not seem to influence the cervical dilatation rate when there is adequate management.
Identifiants
pubmed: 35287161
doi: 10.1371/journal.pone.0262002
pii: PONE-D-20-40976
pmc: PMC8920216
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0262002Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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