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Related Experiment Videos

Active management of labor

A M Peaceman1, M L Socol

  • 1Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA.

American Journal of Obstetrics and Gynecology
|August 1, 1996
PubMed
Summary
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Active management of labor significantly shortens labor duration and reduces maternal infections. While cesarean birth rates saw mixed results, this approach may decrease operative deliveries for dystocia without increasing neonatal risks.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Active management of labor (AML) was developed to shorten labor duration in nulliparous women.
  • Implementation has been associated with decreased cesarean section rates in various institutions.

Purpose of the Study:

  • To evaluate the impact of active management of labor on labor duration, cesarean birth rates, and maternal and neonatal morbidity.
  • To determine if AML is an effective strategy for reducing operative deliveries due to dystocia.

Main Methods:

  • Review of two randomized trials evaluating the active management of labor protocol.
  • Analysis of outcomes including labor duration, cesarean birth rates, maternal infectious morbidity, and neonatal morbidity.

Main Results:

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  • Active management of labor shortened labor by approximately 2 hours.
  • Maternal infectious morbidity decreased by approximately 50%.
  • One trial showed a significant reduction in cesarean birth, while the other did not; no increase in neonatal morbidity was reported.

Conclusions:

  • Active management of labor effectively shortens labor and reduces maternal infectious morbidity.
  • The impact on cesarean birth rates requires further investigation, but AML may be a viable strategy to decrease operative deliveries for dystocia.
  • No adverse neonatal outcomes were associated with this management approach.