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Impact factors on fetal descent rates in the active phase of labor: a retrospective cohort study

  • Nina Kimmich EMAIL logo , Jana Juhasova , Christian Haslinger , Nicole Ochsenbein-Kölble und Roland Zimmermann
Veröffentlicht/Copyright: 25. Juli 2017

Abstract

Aim:

To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors.

Methods:

In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated.

Results:

Fetal descent rates are exponentially increasing. Nulliparous women have slower fetal descent than multiparous women (P<0.001), ranging from 0 to 5.81 cm/h and from 0 to 15 cm/h, respectively. The total duration of fetal descent in labor is 5.42 h for nulliparous and 2.71 h for multiparous women. Accelerating impact factors are a lower fetal station, multiparity, increasing maternal weight and fetal occipitoanterior position, whereas epidural anesthesia decelerates fetal descent (P<0.001).

Conclusions:

Fetal descent is a hyperbolic increasing process with faster descent in multiparous women compared to nulliparous women, is highly inter individual and is associated with different impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates as well as on individual evaluation of every parturient.


Corresponding author: Nina Kimmich, MD, Division of Obstetrics, University Hospital of Zurich, Frauenklinikstr. 10, 8091 Zurich, Switzerland, Tel.: +41-44-255 1111

  1. Author’s statement

  2. Conflict of interest: The authors of this manuscript have no conflicts of interest to disclose as described by the Journal of Perinatal Medicine.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: Approved by the Cantonal Ethical Committee of Zurich, Switzerland, under the registration number KEK-ZH-Nr. 2015-0105.

  5. Contribution to authorship: NK: Study design, data management, statistical analysis, writing of the manuscript; JJ: Data management, statistical analysis; CH: Statistical analysis, revision of the manuscript; NO: Study design, revision of the manuscript; RZ: Study design, revision of the manuscript.

  6. Funding: No funding was obtained for this study.

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Received: 2017-03-06
Accepted: 2017-06-19
Published Online: 2017-07-25
Published in Print: 2018-08-28

©2018 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. A tribute to Ingrid Gruenberg, Managing Editor of the Journal of Perinatal Medicine and Case Reports in Perinatal Medicine
  4. Highlight: Intrapartum Care
  5. Editorial
  6. Intrapartum care
  7. Highlight articles
  8. Trends in characteristics of women choosing contraindicated home births
  9. Impact factors on fetal descent rates in the active phase of labor: a retrospective cohort study
  10. Fetal cardiac time intervals in healthy pregnancies – an observational study by fetal ECG (Monica Healthcare System)
  11. Hypercoiling of the umbilical cord in uncomplicated singleton pregnancies
  12. Validation of a new algorithm for the short-term variation of the fetal heart rate: an antepartum prospective study
  13. Relationship between various maternal conditions and lactic acid dehydrogenase activity in umbilical cord blood at birth
  14. The frequency and type of placental histologic lesions in term pregnancies with normal outcome
  15. Review article
  16. Clinical study of fetal neurobehavior by the KANET test
  17. Regular articles
  18. Maternal demographic factors associated with emergency caesarean section for non-reassuring foetal status
  19. Early usage of Bakri postpartum balloon in the management of postpartum hemorrhage: a large prospective, observational multicenter clinical study in South China
  20. Efficacy of inhaled nitric oxide in neonates with hypoxic respiratory failure and pulmonary hypertension: the Japanese experience
  21. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis
  22. Transfusion-associated necrotizing enterocolitis in preterm infants: an updated meta-analysis of observational data
  23. Commentary
  24. Watch out for congenital Zika syndrome in non-endemic regions
  25. Letters to the Editor
  26. Cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth: is the evidence sufficient?
  27. Reply to: Cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth: is evidence sufficient?
  28. Obituary
  29. Klaus Riegel (1926–2018)
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