The Impact of Parity on Course of Labor in a Contemporary Population

Vahratian, Anjel; Hoffman, Matthew; Troendle, James; Zhang, Jun

doi:10.1111/j.0730-7659.2006.00069.x

Cited by 50 publications

(44 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The different findings in these studies may be attributable to different populations studied and the different labor management protocols used. One study examined progress of labor in nulliparous women undergoing induction, stratified by favorability of the cervix at the time of induction 15 . Similar to our results, they found that progress in one centimeter increments from 3 to 6 cm was slower with the Foley catheter compared to spontaneous labor, but labor patterns were similar thereafter.…”

Section: Commentmentioning

confidence: 99%

Progress of labor in women induced with misoprostol versus the Foley catheter

Tuuli¹,

Keegan²,

Odibo³

et al. 2013

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective To estimate and compare the duration and progress of labor in women induced with misoprostol versus Foley catheter plus oxytocin. Study Design We performed a retrospective cohort study of labor progress among 617 consecutive term pregnancies induced with misoprostol (n=503) or Foley catheter plus oxytocin (n=114) who completed the first stage of labor. Labor duration and progress in the entire cohort, and stratified by parity, were compared in multivariable interval-censored regression models adjusting for maternal obesity and birth weight. Repeated-measures analysis with 9th degree polynomial modeling was used to construct average labor curves. Results Total duration of labor was not significantly different in women induced with misoprostol compared to the Foley catheter median (median duration from 1 to 10 cm: 12 versus 14.2 hours, p=0.19). Progress from 1 to 4 cm was more rapid with the Foley catheter (median: 3.4 versus 5.6 hours, p<0.01), while progress from 4 to 10 cm was slower (median: 6.3 versus 3.6 hours, p<0.01). Labor curves demonstrated transition from latent to active labor at about 4 cm cervical dilatation with misoprostol and at 6cm for the Foley catheter. Similar general patterns were noted for nulliparous and multiparous women, except for a shorter duration of labor with the Foley catheter among multiparous women. Conclusion Induction of labor with the Foley catheter is associated with more rapid initial cervical dilation, but transition to active labor occurs later compared to misoprostol. These differences should be considered in the management of induced labor.

show abstract

Section: Commentmentioning

confidence: 99%

Progress of labor in women induced with misoprostol versus the Foley catheter

Tuuli¹,

Keegan²,

Odibo³

et al. 2013

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

show abstract

“…Compared to multiparous women, primiparas have longer labours [1–3], are at an increased risk of intrapartum complications [4–7] and undergo substantially more obstetric interventions [8–11]. The use of interventions, especially assisted vaginal delivery and unplanned caesarean delivery, has been found to have a negative impact on women’s birth experience, which may partly explain why primiparous birth experiences are more negative [12–14].…”

Section: Introductionmentioning

confidence: 99%

Are freestanding midwifery units a safe alternative to obstetric units for low-risk, primiparous childbirth? An analysis of effect differences by parity in a matched cohort study

Christensen

Overgaard

2017

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundIntrapartum complications and the use of obstetric interventions are more common in primiparous childbirth than in multiparous childbirth, leading to concern about out of hospital birth for primiparous women. The purpose of this study was to determine whether the effect of birthplace on perinatal and maternal morbidity and the use of obstetric interventions differed by parity among low-risk women intending to give birth in a freestanding midwifery unit or in an obstetric unit in the North Denmark Region.MethodsThe study is a secondary analysis of data from a matched cohort study including 839 low-risk women intending birth in a freestanding midwifery unit (primary participants) and 839 low-risk women intending birth in an obstetric unit (individually matched control group). Analysis was by intention-to-treat. Conditional logistic regression analysis was applied to compute odds ratios and effect ratios with 95% confidence intervals for matched pairs stratified by parity.ResultsOn no outcome did the effect of birthplace differ significantly between primiparous and multiparous women. Compared with their counterparts intending birth in an obstetric unit, both primiparous and multiparous women intending birth in a freestanding midwifery unit were significantly more likely to have an uncomplicated, spontaneous birth with good outcomes for mother and infant and less likely to require caesarean section, instrumental delivery, augmented labour or epidural analgesia (although for caesarean section this trend did not attain statistical significance for multiparous women). Perinatal outcomes were comparable between the two birth settings irrespective of parity. Compared to multiparas, transfer rates were substantially higher for primiparas, but fell over time while rates for multiparas remained stable.ConclusionsFreestanding midwifery units appear to confer significant advantages over obstetric units to both primiparous and multiparous mothers, while their infants are equally safe in both settings. Our findings thus support the provision of care in freestanding midwifery units as an alternative to care in obstetric units for all low-risk women regardless of parity. In view of the global rise in caesarean section rates, we consider it an important finding that freestanding midwifery units show potential for reducing first-birth caesarean.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1208-1) contains supplementary material, which is available to authorized users.

show abstract

“…12,20 When cervical dilatation occurs rapidly, a short duration of labor could explain the low analgesic effectiveness of the epidural technique. 21 We found that nationality was not associated with epidural analgesia effectiveness. Besides, a recent single-center prospective observational study reported that ethnicity plays at most a small role in the acceptance of and requests for neuraxial analgesia.…”

Section: Discussionmentioning

confidence: 64%