TITLE:
Changing Trends in Rate of Cervical Dilation in First Stage of Labor: Prospective Longitudinal Study
AUTHORS:
Divyesh V. Shukla, Shilpi D. Shukla, Sangita Patel, Amit Shah
KEYWORDS:
Cervical Dilatation, Spontaneous Labour, Induced Labour, Active Phase of Labour
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.9,
September
10,
2020
ABSTRACT: Introduction: Knowledge of change in the duration of stages of labour would be an essential
step to reduce the increasing rates of cesarean section reported worldwide. Objective: To study the rate of
cervical dilation in the 1st stage of labour in spontaneous and induced labour and in primigravida and
multigravida with singleton pregnancy. Methods: A prospective observational study conducted at a multispeciality
hospital was carried out for a period of 3 years from Jan 2017 to Dec 2019. A total of 640 patients who were
admitted with spontaneous and induced labour having singleton pregnancy with
cephalic presentation and intact membranes after 34 weeks who delivered
vaginally were included for analysis. Progression of labor in the 1st stage of
labour was measured by the rate of cervical dilation as noted by serial per vaginal examination and
findings were plotted in partograph. Result: The difference between mean rate of cervical dilation in the study group is statistically
significant between 4 - 6 cm and 6 - 10 cm (P ). When
primigravida & multigravida patients were compared for the cervical
dilation rate, statistically significant difference was seen between 4 - 6 cm
but not in 6 - 10 cm. Average rate of cervical dilatation was 3.44 (Standard Deviation (SD) = 1.84) in spontaneous labor
while average rate of cervical dilatation was 2.69 (SD = 1.18) in induced labor between
6 - 10 cm of cervical dilatation. Conclusion: The active phase of labour starts at 6 cm of cervical
dilation in the majority of the patients. In multigravida, cervix
dilates at faster rate before 6 cm. In induced labour cervix dilates at a
slower rate than spontaneous labour after 6 cm dilation.