Timing of hospital admission in labour: latent versus active phase, mode of birth and intrapartum interventions. A correlational study

Rota, A.; Antolini, Laura; Colciago, Elisabetta; Nespoli, Antonella; Borrelli, Sara E.; Fumagalli, Simona

doi:10.1016/j.wombi.2017.10.001

Cited by 42 publications

(44 citation statements)

References 22 publications

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“…In this first Australian assessment of the prevalence of hospital admission in early labour, the identified rate of 32.4% falls at approximately the midpoint of the 10.2 to 58.5% range found in previous retrospective cohort studies in Sweden [1], Iran [2], Canada [3], the United States [4], Bangladesh [5] and Italy [6]. Our estimates of the 52.9% prevalence of hospital admission in early labour when applying the criteria of at least 5 cm of cervical dilatation at time of admission compare with 60.3% of women admitted in early labour in a sample of Australian women in a randomised controlled trial which also employed criterion of < 5 cm cervical dilatation [15].…”

Section: Discussionmentioning

confidence: 72%

“…Eligible for inclusion in the study were women who gave birth in Caboolture Hospital in three chosen time periods 1 where women [1] had a singleton pregnancy, [2] planned to have a vaginal birth (i.e. did not have a caesarean section scheduled in advance of labour onset), [3] had spontaneous onset of labour while not a hospital inpatient (women admitted for birth after rupture of membranes were regarded as being in early labour at time of admission if cervical dilatation was recorded as < 4 cm), [4] were at ≥37 weeks' gestation, [5] did not give birth prior to hospital admission [6] had a live birth and [7] had at least one vaginal examination recorded during the episode of hospital admission. The data collection periods were selected to allow secondary usage of the data for a different project utilising a time series design for evaluating upcoming service changes.…”

Section: Study Design and Settingmentioning

confidence: 99%

“…Evidence from large international retrospective cohort studies [1][2][3][4][5][6] suggests between 10.2% [1] and 58.5% [2] of women are admitted to hospital in latent phase ('early') labour. International guidelines recommend a delay in hospital admission during the early phase of labour by supporting women to stay at home [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Miller

Armanasco

McCosker

et al. 2020

BMC Pregnancy Childbirth

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Background: There is no available evidence for the prevalence of early labour admission to hospital or its association with rates of intervention and clinical outcomes in Australia. The objectives of this study were to: estimate the prevalence of early labour admission in one hospital in Australia; compare rates of clinical intervention, length of hospital stay and clinical outcomes for women admitted in early (< 4 cm cervical dilatation) or active (≥4 cm) labour; and determine the impact of recent recommendations to define early labour as < 5 cm on the findings. Methods: We conducted a retrospective cohort study using medical record data from a random sample of 1223 women from live singleton births recorded between July 2013 and December 2015. Analyses included women who had spontaneous onset of labour at ≥37 weeks gestation whilst not a hospital inpatient, who had not scheduled a caesarean section before labour onset or delivered prior to hospital admission. Associations between timing of hospital admission in labour and clinical intervention, outcomes and hospital stay were assessed using logistic regression. Results: Between 32.4% (< 4 cm) and 52.9% (< 5 cm) of eligible women (N = 697) were admitted to hospital in early labour. After adjustment for potential confounders, women admitted in early labour (< 4 cm) were more likely to have their labour augmented by oxytocin (AOR = 3.57, 95% CI 2.39-5.34), an epidural (AOR = 2.27, 95% CI 1.51-3.41), a caesarean birth (AOR = 3.50, 95% CI 2.10-5.83), more vaginal examinations (AOR = 1.73, 95% CI = 1.53-1.95), and their baby admitted to special care nursery (AOR = 1.54, 95% CI = 1.01-2.35). Defining early labour as < 5 cm cervical dilatation produced additional significant associations with artificial rupture of membranes (AOR = 1.41, 95% CI = 1.02-1.95), assisted vaginal birth (AOR = 1.96, 95% CI = 1.12-3.41) neonatal resuscitation (AOR = 1.73, 95% CI = 1.01-2.99) and longer maternal hospital stay (AOR = 1.21, 95% CI = 1.04-1.40). Conclusions: Findings provide preliminary evidence that a notable proportion of labouring women are admitted in early labour and are more likely to experience several medical procedures, neonatal resuscitation and admission to special care nursery, and longer hospital stay.

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Section: Discussionmentioning

confidence: 72%

Section: Study Design and Settingmentioning

confidence: 99%

See 1 more Smart Citation

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Miller

Armanasco

McCosker

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…Oxycodone (Oxanest®; Takeda Oy) was administered according to the hospital protocol during the first stage of labour: in the latent phase, an initial dose of 0.1 mg/kg s.c. injection of oxycodone hydrochloride with a maximum dose of 10 mg was administered, and four hours later, further doses of 0.05 mg/kg (maximum 5 mg) could be administered if required, no more frequently than every four hours. Latent phase was defined as the part of first stage of labour, where painful contractions were frequent and cervical changes occurred, and cervical dilatation was up to 4 cm . An attending obstetrician who was unaware of whether a parturient was participating in the study decided on oxycodone administration based on the clinical evaluation.…”

Section: Methodsmentioning

confidence: 99%

“…Latent phase was defined as the part of first stage of labour, where painful contractions were frequent and cervical changes occurred, and cervical dilatation was up to 4 cm. 13 An attending obstetrician who was unaware of whether a parturient was participating in the study decided on oxycodone administration based on the clinical evaluation. During the latent phase, no opioids other than oxycodone were allowed.…”

Section: Me Thodsmentioning

confidence: 99%

Oxycodone for pain management in the latent phase of labour – A pragmatic trial

Kinnunen

Kokki

Hautajärvi

et al. 2020

Acta Anaesthesiol Scand

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Background Parenteral opioids are used for pain relief in labour but there are little data for oxycodone in this context. The aim of this study was to evaluate the efficacy, foetal exposure and safety of subcutaneous oxycodone in the latent phase of labour. Methods This pragmatic trial included 76 parturients, who received subcutaneous oxycodone for pain relief in the latent phase of labour according to the hospital protocol: an initial dose 0.1 mg/kg, and a second dose, 0.05 mg/kg, could be administered four hours later. Pain intensity and pain relief were assessed using a numerical rating scale of 0‐10. After delivery, blood samples from the maternal and umbilical veins were collected, and plasma concentrations of oxycodone and its main metabolites were quantified using UPLC‐MS/MS. The Apgar scores and maternal and neonatal adverse effects were recorded. Results The foetal exposure at birth was low, the median oxycodone and oxymorphone umbilical vein plasma concentrations were 1.2 ng/mL (range 0.21‐7.8) and 0.14 ng/mL (0‐0.26), respectively. Pain scores decreased substantially, from a median pain score of 7/10 before oxycodone to median scores of 5/10 at 30 minutes after administration, 5/10 at 60 minutes and 6/10 at 120 minutes. The median Apgar score was 9 (range 2‐10) at 1 minute and 9 (6‐10) at 5 minutes. Maternal adverse effects were mild, and there were no oxycodone‐related neonatal adverse effects. Conclusion Subcutaneous oxycodone provided effective analgesia during the latent phase of labour. Newborn exposure at birth was low, and oxycodone was well‐tolerated.

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Planned hospital birth compared with planned home birth for pregnant women at low risk of complications

Olsen

Clausen²

2023

Cochrane Database of Systematic Reviews

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Timing of hospital admission in labour: latent versus active phase, mode of birth and intrapartum interventions. A correlational study

Cited by 42 publications

References 22 publications

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Oxycodone for pain management in the latent phase of labour – A pragmatic trial

Planned hospital birth compared with planned home birth for pregnant women at low risk of complications

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