ArticleBirth (Berkeley, Calif.)2017
Likelihood of cesarean delivery after applying leading active labor diagnostic guidelines.
Article in Birth (Berkeley, Calif.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic accuracy of the partograph alert and action lines to predict adverse birth outcomes: a systematic review.BJOG : an international journal of obstetrics and gynaecology · 2019Pooled it
- Inconsistent definitions of prolonged labor in international literature: a scoping review.AJOG global reports · 2024Article
- First stage of labour duration and associated risk of adverse neonatal outcomes.Scientific reports · 2023Article
- Spontaneous vaginal birth varies significantly across US hospitals.Birth (Berkeley, Calif.) · 2021Article
- A qualitative meta-synthesis of women's experiences of labor dystocia.Women and birth : journal of the Australian College of Midwives · 2020Article
- Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: A Consortium on Safe Labor study.Birth (Berkeley, Calif.) · 2019Observational
- Applying a physiologic partograph to Consortium on Safe Labor data to identify opportunities for safely decreasing cesarean births among nulliparous women.Birth (Berkeley, Calif.) · 2018Observational
- Likelihood of cesarean birth among parous women after applying leading active labor diagnostic guidelines.Midwifery · 2018Article
- Challenges in the Triage Care of Low-Risk Laboring Patients: A Comparison of 2 Models of Practice.The Journal of perinatal & neonatal nursingArticle
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7 authors.
Funding
Abstract
backgroundFriedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons).
designActive labor diagnostic guidelines were retrospectively applied to cervical examination data from nulliparous women with spontaneous labor onset (n = 2573). Generalized linear models were used to determine outcome likelihoods within- and between-guideline groups.
resultsAt admission, 15.7%, 48.3%, and 10.1% of nulliparous women were in active labor per Friedman, NICE, and ACOG/SMFM diagnostic guidelines, respectively. Cesarean delivery was more likely among women admitted before vs in active labor per the Friedman (AOR 1.75 [95% CI 1.08-2.82] or NICE guideline (AOR 2.55 [95% CI 1.84-3.53]). Between guidelines, cesarean delivery was less likely among women admitted in active labor per the NICE guideline, as compared with the ACOG/SMFM guideline (AOR 0.55 [95% CI 0.35-0.88]).
conclusionMany nulliparous women are admitted to the hospital before active labor onset. These women are significantly more likely to have a cesarean delivery. Diagnosing active labor before admission or before intervention to speed labor may be one component of a multi-faceted approach to decreasing the primary cesarean rate in the United States. The NICE diagnostic guideline is more inclusive than Friedman or ACOG/SMFM guidelines and its use may be the most clinically useful for safely lowering cesarean rates.
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