FC1.26How long is the latent phase of labour?Loi, G1; Meloni, A1; Melis, GB1; Deiana, S1; Diaz,G2; Ferrazzi, E3; Ragusa, A41Clinica Ostetrica Ginecologica Ospedale San Giovanni di Dio,Cagliari;2Dipartimento di Scienze e Tecnologie Biomediche, Cagliari;3Clinica Ostetrica Ginecologica Ospedale dei bambini V. Buzzi,Milano;4Reparto di Ostetricia e Ginecologia Ospedale di Niguarda,MilanoObjective:Modern delivery-room practices owe much to thestudies of Doctor Friedman. However, the patients he consideredhad different features if compared to modern ones, as his studieswere held in the last century. Doctor Friedman claimed that thelatent phase of labour had to be considered prolonged if it wasover 14 h for nulliparous women and over 20 h for multiparouswomen. In order to update these data, we have conducted aprospective cohort study to analyse the duration of latent phase oflabour in our population.Methods:In our research we have taken into considerationwomen who were between the 37th and the 42nd week ofgestation, with singleton physiological pregnancy and fetus incephalic presentation, who presented to Niguarda Hospital inMilan between June 2009 and June 2010 for one of theseconditions: contractile activity, premature rupture of membrane,blood loss. On the whole, we have collected 537 cases; amongthese, we have selected the ones whose first labour diagnosisproved to be right. The data have been accurately collected by tworesearchers. Overall, these patients have resulted being 308, ofwhich 155 nulliparous and 153 multiparous.Results:Statistical analysis shows that in nulliparous women theaverage length of the latent phase is of 155 min (2.58 h) and the95°centile takes 415 min (6.9 h), while for multiparous womenthe average length of the same phase is of 81 min (1.35 h) andthe 95°centile takes 315 min (5.25 ore). As a consequence, anulliparous woman can be considered in a prolonged latent phaseof labour if, after 7 h since contractions have begun, active labourhas not started yet; a multiparous woman can be considered in aprolonged latent phase of labour if, after five and a half hourssince contractions have begun, active labour has not started yet.Conclusion:Prolonged latent phase of labour is a condition thatcan lead to negative maternal-fetal outcomes. At present times,two types of intervention are proposed to solve the prolongedlatent phase: it is possible to accelerate the labour, or, inversely, tosedate the patient, either pharmacologically or non-pharmacologically. Beyond personal beliefs, the most importantthing is to ascertain whether the patient has entered the prolongedlatent phase of labour, in order to intervene promptly and thusimprove maternal
Diagnosis of labour: the II prospective clinical study
Ragusa A.
2012-01-01
Abstract
FC1.26How long is the latent phase of labour?Loi, G1; Meloni, A1; Melis, GB1; Deiana, S1; Diaz,G2; Ferrazzi, E3; Ragusa, A41Clinica Ostetrica Ginecologica Ospedale San Giovanni di Dio,Cagliari;2Dipartimento di Scienze e Tecnologie Biomediche, Cagliari;3Clinica Ostetrica Ginecologica Ospedale dei bambini V. Buzzi,Milano;4Reparto di Ostetricia e Ginecologia Ospedale di Niguarda,MilanoObjective:Modern delivery-room practices owe much to thestudies of Doctor Friedman. However, the patients he consideredhad different features if compared to modern ones, as his studieswere held in the last century. Doctor Friedman claimed that thelatent phase of labour had to be considered prolonged if it wasover 14 h for nulliparous women and over 20 h for multiparouswomen. In order to update these data, we have conducted aprospective cohort study to analyse the duration of latent phase oflabour in our population.Methods:In our research we have taken into considerationwomen who were between the 37th and the 42nd week ofgestation, with singleton physiological pregnancy and fetus incephalic presentation, who presented to Niguarda Hospital inMilan between June 2009 and June 2010 for one of theseconditions: contractile activity, premature rupture of membrane,blood loss. On the whole, we have collected 537 cases; amongthese, we have selected the ones whose first labour diagnosisproved to be right. The data have been accurately collected by tworesearchers. Overall, these patients have resulted being 308, ofwhich 155 nulliparous and 153 multiparous.Results:Statistical analysis shows that in nulliparous women theaverage length of the latent phase is of 155 min (2.58 h) and the95°centile takes 415 min (6.9 h), while for multiparous womenthe average length of the same phase is of 81 min (1.35 h) andthe 95°centile takes 315 min (5.25 ore). As a consequence, anulliparous woman can be considered in a prolonged latent phaseof labour if, after 7 h since contractions have begun, active labourhas not started yet; a multiparous woman can be considered in aprolonged latent phase of labour if, after five and a half hourssince contractions have begun, active labour has not started yet.Conclusion:Prolonged latent phase of labour is a condition thatcan lead to negative maternal-fetal outcomes. At present times,two types of intervention are proposed to solve the prolongedlatent phase: it is possible to accelerate the labour, or, inversely, tosedate the patient, either pharmacologically or non-pharmacologically. Beyond personal beliefs, the most importantthing is to ascertain whether the patient has entered the prolongedlatent phase of labour, in order to intervene promptly and thusimprove maternalI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
