Identification of high risk labours by labour nomogram

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Assessing labor progress is crucial for identifying deviations from normal progression.
• The labor stencil provides a visual tool for monitoring cervimetric progress during spontaneous labor.

Purpose of the Study:

• To evaluate the effectiveness of a labor stencil in identifying high-risk labors requiring oxytocic stimulation.
• To compare outcomes between stimulated and unstimulated labors identified as high-risk.

Main Methods:

• A labor stencil was applied to 741 consecutive spontaneous labors to track cervimetric progress.
• Uterine contractions were stimulated if labor progress exceeded the nomogram by two hours.

Main Results:

• Stimulated labors were shorter with fewer instrumental deliveries and cesarean sections.
• Babies in stimulated labor groups had higher Apgar scores.
• 36% of primigravid and 13% of multigravid labors required acceleration.

Conclusions:

• The labor stencil effectively identifies labors needing oxytocic stimulation, leading to improved maternal and neonatal outcomes.
• This selective stimulation approach supports the safe implementation of active labor management, addressing public and professional concerns.