Abstract
Aims:
To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors.
Methods:
In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated.
Results:
Cervical dilation rates increase during labor progress with faster rates in multiparous compared with nulliparous women (P<0.001). Dilation rates exceed 1 cm/h at a dilatation of 6–7 cm, but are very individual. Accelerating impact factors are multiparity, a greater amount of cervical dilation and fetal occipitoanterior position, whereas the use of epidural anesthesia, a higher fetal weight and head circumference decelerate dilation (P<0.001).
Conclusion:
Cervical dilation is a hyperbolic increasing process, with faster dilation rates in multiparous compared to nulliparous women and a reversal point of labor around 6–7 cm, respectively. Besides, cervical dilation is highly individual and affected by several impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates and on the individual evaluation of every woman.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Contribution to authorship: JJ: Data management, statistical analysis, writing of the manuscript. MK: Study design and revision of the manuscript. RZ: Study design and revision of the manuscript. NK: Study design, data management, statistical analysis and writing of the manuscript.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
Funding: No funding was obtained for this study.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review article
- The assessment of labor: a brief history
- Original articles – Obstetrics
- The combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome increases the risk of intraventricular hemorrhage in preterm neonates
- Uterine artery Doppler pulsatility index at 11–38 weeks in ICSI pregnancies with egg donation
- Violence before pregnancy and the risk of violence during pregnancy
- Cancer during pregnancy – clinical characteristics, treatment outcomes and prognosis for mothers and infants
- The effect of attending a prenatal childbirth preparedness course on labor duration and outcomes
- Serum fibrinogen levels could be an index of successful use of balloon tamponade in postpartum hemorrhage
- Impact factors on cervical dilation rates in the first stage of labor
- Feasibility and acceptability of text messaging to support antenatal healthcare in Iraqi pregnant women: a pilot study
- Clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death
- Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
- The association between pre-pregnancy obesity and screening results of depression for all trimesters of pregnancy, postpartum and 1 year after birth: a cohort study
- Original articles – Fetus
- Causes of intrauterine fetal death are changing in recent years
- Original articles – Newborn
- Proactive approach at the limits of viability improves the short-term outcome of neonates born after 23 weeks’ gestation
- Letter to the Editor
- Exact days of gestation necessary for infants at borderline viability: reply to Proactive approach at the limits of viability improves the short-term outcome of neonates born after 23weeks’ gestation. P. Šimják, J. Smíšek, M. Koucký, T. Lamberská, R. Plavka and Z. Hájek. J Perinat Med 2017
Articles in the same Issue
- Frontmatter
- Review article
- The assessment of labor: a brief history
- Original articles – Obstetrics
- The combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome increases the risk of intraventricular hemorrhage in preterm neonates
- Uterine artery Doppler pulsatility index at 11–38 weeks in ICSI pregnancies with egg donation
- Violence before pregnancy and the risk of violence during pregnancy
- Cancer during pregnancy – clinical characteristics, treatment outcomes and prognosis for mothers and infants
- The effect of attending a prenatal childbirth preparedness course on labor duration and outcomes
- Serum fibrinogen levels could be an index of successful use of balloon tamponade in postpartum hemorrhage
- Impact factors on cervical dilation rates in the first stage of labor
- Feasibility and acceptability of text messaging to support antenatal healthcare in Iraqi pregnant women: a pilot study
- Clinical characteristics and outcome of twin pregnancies complicated by single intrauterine death
- Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
- The association between pre-pregnancy obesity and screening results of depression for all trimesters of pregnancy, postpartum and 1 year after birth: a cohort study
- Original articles – Fetus
- Causes of intrauterine fetal death are changing in recent years
- Original articles – Newborn
- Proactive approach at the limits of viability improves the short-term outcome of neonates born after 23 weeks’ gestation
- Letter to the Editor
- Exact days of gestation necessary for infants at borderline viability: reply to Proactive approach at the limits of viability improves the short-term outcome of neonates born after 23weeks’ gestation. P. Šimják, J. Smíšek, M. Koucký, T. Lamberská, R. Plavka and Z. Hájek. J Perinat Med 2017