First stage of labor progression in women with large-for-gestational age infants

Blankenship, Stephanie A.; Woolfolk, Candice; Raghuraman, Nandini; Stout, Molly J.; Macones, George A.; Cahill, Alison G.

doi:10.1016/j.ajog.2019.06.042

Cited by 13 publications

(16 citation statements)

References 23 publications

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“…Prolonged second stage as an indication for VE increased significantly with every additional 500 g of neonatal BW, as did the durations of the first and second stages of labor. This is a reasonable difference because high fetal weight is a known risk factor for prolonged first and second stages of labor [29,30]. Prolonged labor may explain why we found higher rates of intrapartum fever in women delivering higher BW neonates.…”

Section: Principal Findingsmentioning

confidence: 67%

Head Injuries Related to Birth Trauma in Low Birthweight Neonates During Vacuum Extraction

Cohen

Schreiber

Mevorach

et al. 2023

Geburtshilfe Frauenheilkd

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Introduction Preterm delivery (gestational age < 34 w) is a relative contraindication to vacuum extraction. Current data do not differentiate clearly between preterm delivery and low birthweight. We aimed to evaluate the impact of non-metal vacuum cup extraction on neonatal head injuries related to birth trauma in newborns with low birthweights (< 2500 g). Materials and Methods A retrospective cohort of 3377 singleton pregnancies delivered by vacuum extraction from 2014 to 2019. All were gestational age ≥ 34 w. We compared 206 (6.1%) neonates with low birthweights < 2500 g to 3171 (93.9%) neonates with higher birthweights, divided into 3 subgroups (2500–2999 g, 3000–3499 g, and ≥ 3500 g). A primary composite outcome of neonatal head injuries related to birth trauma was defined. Results The lowest rates of subgaleal hematoma occurred in neonates < 2500 g (0.5%); the rate increased with every additional 500 g of neonatal birthweight (3.5%, 4.4% and 8.0% in the 2500–2999 g, 3000–3499 g, and ≥ 3500 g groups, respectively; p = 0.001). Fewer cephalohematomas occurred in low birthweight neonates (0.5% in < 2500 g), although the percentage increased with every additional 500 g of birthweight (2.6%, 3.3% and 3.7% in the 2500–2999 g, 3000–3499 g, and ≥ 3500 g groups, respectively, p = 0.020). Logistic regression found increasing birthweight to be a significant risk factor for head injuries during vacuum extraction, with adjusted odds ratios of 8.12, 10.88, and 13.5 for 2500–2999 g, 3000–3499 g, and ≥ 3500 g, respectively (p = 0.016). NICU hospitalization rates were highest for neonates weighing < 2500 g (10.2%) compared to the other groups (3.1%, 1.7% and 3.3% in 2500–2999 g, 3000–3499 g, ≥ 3500 respectively, p < 0.001). Conclusions Vacuum extraction of neonates weighing < 2500 g at 34 w and beyond seems to be a safe mode of delivery when indicated, with lower rates of head injury related to birth trauma, compared to neonates with higher birthweights.

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Section: Principal Findingsmentioning

confidence: 67%

Head Injuries Related to Birth Trauma in Low Birthweight Neonates During Vacuum Extraction

Cohen

Schreiber

Mevorach

et al. 2023

Geburtshilfe Frauenheilkd

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“…Parity has proved to be the main contributing factor for the DT [12], and the DT can be obviously decreased in multiparous women compared with nulliparous women [13,14]. In the study by Stephanie A et al, the dilation time from 6-10 cm was 3.28 hours in nulliparous women, which was signi cantly slower than that of 2.03 hours in multiparous women [15].…”

Section: Discussionmentioning

confidence: 95%

A model to predict delivery time by induction of labour at term with a dinoprostone vaginal insert：A retrospective study

Huang

Chen

et al. 2022

Preprint

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Background: Dinoprostone vaginal insert is the most common pharmacological method of induction of labour for pregnant women. Few studies have predicted the vaginal delivery time (DT), our study aimed to analyse the primary factors for DT among women at or beyond term who underwent labour induction with dinoprostone vaginal inserts in the middle of China. Methods: In this retrospective observational study performed in the obstetric ward in Zhongnan Hospital of Wuhan University, we ultimately included all women at37 weeks 0 days to 41 weeks 6 days of gestation who underwent labour induction with vaginal dinoprostone between January 1st, 2019, and December 31st, 2021. The primary outcome was vaginal or caesarean delivery; the principal secondary outcome was influence for DT including several maternal complications and neonatal characteristics. Results: A total of 1,562 women at or beyond term underwent labour induction, and 71% (1109/1562) delivered vaginally. The median delivery time (DT) was 740.50 min, with an interquartile range from 443.25 to 1264.50 min. A total of 29% (453/1562) of the women gave birth by caesarean section, and 11.9% (54/453) were multiparous. Multiple linear regression analysis showed that multiparity, advanced maternal age, foetal macrosomia, premature rupture of membranes (PROM), and having dinoprostone inserted during the day all significantly influenced DT. A mathematical model was developed to integrate these factors for predicting DT: Y=804.478–125.284 × multiparity + 765.637 × advanced maternal age + 411.511 × foetalmacrosomia-593.358 × dinoprostone inserted during the day - 125.284×PROM. Conclusions: The DT with dinoprostone vaginal inserts was increased in women with advanced maternal age and foetal macrosomia, but decreased in multiparity, PROM, and dinoprostone inserted during the day.This study allows obstetricians to calculate a preliminary DT for pregnant women before placing a dinoprostone insert, which may be helpful to improve the management of patients and reduce the risk in busy maternity wards.

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“…27 In studies examining both women with GDM and women with pre-pregnancy diabetes, Hawkins et al 14 GDM was an independent risk factor for failure of labor to progress during the first stage. 28 Looking at the aspect of LGA on time in active labor, Blankenship et al 29 showed that the time required to reach the second stage of labor was longer in women with LGA infants compared to those with appropriate-for-gestational age infants. In this retrospective cohort study, 17 097 women were included and 1254 (7.3%) had an LGA infant.…”

Section: Women With Gdm N = 2978mentioning

confidence: 99%

Gestational diabetes mellitus and time in active labor: A population‐based cohort study

Nevander

Carlhäll

Källén

et al. 2023

Acta Obstet Gynecol Scand

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Introduction:Women with gestational diabetes mellitus (GDM) have higher rates of adverse perinatal outcomes compared with women without GDM, including an increased risk for having labor induced and for cesarean section. The findings from previous studies analyzing duration of labor in women with GDM are contradictory.The aim of the study was to evaluate the impact of GDM on time in spontaneous and induced active labor. Material and methods:This was a population-based cohort study including 247 524 primiparous women who gave birth to a singleton fetus with cephalic presentation, ≥34 +0 (completed gestational weeks + additional days) between January 2014 and May 2020 in Sweden. Data was obtained from the Swedish Pregnancy Register. Time in active labor was compared between women with GDM and without GDM with a spontaneous labor onset or induction of labor using Kaplan Meier survival analysis and Cox regression analysis.Results: Women with GDM had significantly longer time in active labor, both with a spontaneous onset and induction of labor compared to women without GDM.Women with GDM had a decreased chance of vaginal delivery at a certain time-point compared to women without GDM, with adjusted hazard ratio of 0.92 (0.88-0.96) and 0.83 (0.76-0.90) for those with spontaneous onset and induction of labor, respectively. Women with GDM had increased risk for time in active labor ≥12 h both in spontaneous labor onset (adjusted odds ratio 1. 14 [1.04-1.25]) and in induction of labor (adjusted odds ratio 1. 55 [1.28-1.87]). Conclusions:Women with GDM seem to spend a longer time in active labor, both in spontaneous and induced active labor compared to women without GDM. To be able to individualize care intrapartum, there is a need for more studies demonstrating the impact of hyperglycemia during pregnancy on outcomes during childbirth.

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First stage of labor progression in women with large-for-gestational age infants

Cited by 13 publications

References 23 publications

Head Injuries Related to Birth Trauma in Low Birthweight Neonates During Vacuum Extraction

Head Injuries Related to Birth Trauma in Low Birthweight Neonates During Vacuum Extraction

A model to predict delivery time by induction of labour at term with a dinoprostone vaginal insert：A retrospective study

Gestational diabetes mellitus and time in active labor: A population‐based cohort study

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