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A second-stage partogram.

A R Sizer1, J Evans, S M Bailey

  • 1Department of Obstetrics and Gynecology, University Hospital of Wales, Cardiff, United Kingdom. sizer@cardiff.ac.uk

Obstetrics and Gynecology
|October 24, 2000
PubMed
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A new scoring system for the second stage of labor accurately predicts delivery mode and outcomes. This second-stage partogram provides an objective tool for managing labor progress and informing clinical decisions.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Labor and Delivery Management

Background:

  • The second stage of labor requires careful monitoring for optimal maternal and fetal outcomes.
  • Predicting the mode of delivery and labor duration is crucial for effective obstetric management.

Purpose of the Study:

  • To introduce and validate a novel second-stage partogram utilizing a fetal head descent and position scoring system.
  • To assess the system's ability to predict delivery mode, labor duration, and obstetric outcomes.

Main Methods:

  • A prospective observational study involving 1413 women with singleton, cephalic presentations at term.
  • Fetal head position and station were scored at the start of the second stage and at regular intervals.
  • A normogram was developed to define normal versus abnormal labor progress and analyze associated factors.

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Main Results:

  • Higher scores at the second stage onset correlated with increased spontaneous vaginal delivery and decreased operative delivery rates.
  • Abnormal labor progress was linked to epidural anesthesia, labor induction/augmentation, dystocia, and higher operative delivery incidence.
  • No significant differences in fetal outcomes (Apgar scores) were observed between normal and abnormal second stages of labor.

Conclusions:

  • The developed second-stage partogram provides an objective framework for managing the second stage of labor.
  • This tool aids in predicting delivery outcomes and identifying deviations from normal labor progress.