Am J Perinatol 2021; 38(S 01): e14-e20
DOI: 10.1055/s-0040-1702989
Original Article

A Novel Partogram for Stages 1 and 2 of Labor Based on Fetal Head Station Measured by Ultrasound: A Prospective Multicenter Cohort Study

Shoshana Haberman
1  Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Maimonides Medical Center, Brooklyn, New York
,
Fouad Atallah
1  Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Maimonides Medical Center, Brooklyn, New York
,
Jacky Nizard
2  Service de gynécologie obstétrique, Groupe hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, Paris, France
,
Olive Buhule
3  National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Paul Albert
3  National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Ron Gonen
4  Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Bnai Zion Medical Center, Technion, Israel Institute of Technology, Israel
,
Yves Ville
5  Department of Obstetrics and Fetal Medicine, Hôpital Necker-Enfants-Malade, Paris, France
,
Yoav Paltieli
4  Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Bnai Zion Medical Center, Technion, Israel Institute of Technology, Israel
› Author Affiliations

Abstract

Objective This study was aimed to describe continuous labor curves, including second stage, based on fetal head station.

Study Design We performed a prospective multicenter cohort study. The inclusion criteria were women with singleton uncomplicated cephalic term pregnancies in labor, who delivered vaginally. We used a device that combines ultrasound imaging with position-tracking technology to monitor the head station noninvasively throughout labor. We collected data on demographics, labor parameters, and delivery and neonatal outcomes.

Results A total of 613 women delivered vaginally, 327 (53.3%) were nulliparous, while 286 (46.7%) were multiparous. Time to delivery (TTD) diminished progressively with descent of the fetal head. When the head is engaged, the labor curve of multiparous women demonstrated a more prominent downward shift in curve as compared with nulliparous women. When comparing multipara and nullipara at engagement level, the median TTD was 1 and 1.62 hours, respectively. In 95% of women with unengaged head during the second stage, TTD of nulliparous and multiparous women were less than 3.8 and 3 hours, respectively.

Conclusion While current labor curves end at full dilatation, the described curves were developed throughout stages 1 and 2 of labor. The TTD, according to the station curves, shows an acceleration of labor, once passed the engagement level, especially in multiparous women.

Note

ClinicalTrials.gov Identifier: NCT00827125.




Publication History

Received: 05 August 2019

Accepted: 19 January 2020

Publication Date:
02 March 2020 (online)

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