Should a different Partogram be used for the Trial of Labour in Women with the Previous One Caesarean Section Scar as Compared to Primiparous Women; A Comparative study
DOI:
https://doi.org/10.51253/pafmj.v74i1.9511Keywords:
Caesarean section, Parity, Gravidity, Labor Pain, Fetal monitoring, Trial of labor, Catheterization, Uterine monitoringAbstract
Objective: To compare various labour parameters in partogram among primiparous women and women with one previous caesarean section scar
Study Design: Comparative cross-sectional study
Place and Duration of Study: Gynaecology and Obstetrics Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Oct 2021 to Sep 2022.
Methodology: This study was conducted on primiparous women and women with one previous scar who were booked cases in our department for antenatal checkups and labour. Patients were divided into two groups for comparison. Group-I were primiparous, while Group-II had one previous scar. All women underwent detailed labour records via conventional partogram in the labour room. Duration of the active phase of labour, duration of the second stage, time to progress by 1 cm and time after the alert line were compared in partograms of both the study groups.
Results: A total of 390 women who were either primiparous or had one previous caesarean section were recruited for this study. Of the study participants, 226(42.6%) were primiparous, while 164(57.4%) had one previous caesarean section scar. Statistical analysis revealed that the duration of the active phase of labour, time to progress by 1 cm and time after the alert line were statistically significant (p-value<0.05) in partograms of women in Group-I (primiparous) as compared to those in Group- II (women with one previous scar) (p-value<0.05).
Conclusion: The main parameters of the partogram differ significantly among primiparous women and women with one previous caesarean section scar.
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References
Eze P, Lawani LO, Chikezie RU, Ukaegbe CI, Iyoke CA.
Perinatal outcomes of babies delivered by second-stage
Caesarean section versus vacuum extraction in a resource-poor
setting, Nigeria - a retrospective analysis. BMC Pregnancy
Childbirth 2020; 20(1): 298. https://doi.org/10.1186/s12884-
-02995-9
Shmueli A, Salman L, Ashwal E, Hiersch L, Gabbay-Benziv R,
Yogev Y, et al. Perinatal outcomes of vacuum assisted versus
cesarean deliveries for prolonged second stage of delivery at
term. J Matern Fetal Neonatal Med 2017; 30(8): 886-889.
https://doi.org/10.1080/14767058.2016.1191066
Benedetto C, Marozio L, Prandi G, Roccia A, Blefari S, Fabris C.
Short-term maternal and neonatal outcomes by mode of
delivery. A case-controlled study. Eur J Obstet Gynecol Reprod
Biol 2007; 135(1): 35-40.
https://doi.org/10.1016/j.ejogrb.2006.10.024
Tufail A, Qayyum A, Naheed F, Ahsan NA, Jehan M. The
impact of mode of delivery on maternal and perinatal outcome
in vertex / breech presentation in the leading twin. J Surg Pak
; 25 (2): 77-82. https://doi.org/10.21699/jsp.25.2.7
Kvalvik LG, Wilcox AJ, Skjærven R, Østbye T, Harmon QE.
Term complications and subsequent risk of preterm birth:
registry based study. BMJ 2020; 369: m1007.
https://doi.org/10.1136/bmj.m1007
Matta P, Turner J, Flatley C, Kumar S. Prolonged second stage
of labour increases maternal morbidity but not neonatal
morbidity. Aust N Z J Obstet Gynaecol 2019; 59(4): 555-560.
https://doi.org/10.1111/ajo.12935
Lavender T, Cuthbert A, Smyth RM. Effect of partograph use
on outcomes for women in spontaneous labour at term and
their babies. Cochrane Database Syst Rev 2018; 8(8):
CD005461.https://doi.org/10.1002/14651858.CD005461.pub5
Rajole KM, Agrawal V. Evaluation of role of partograph in the
management of labour in previous caesarean section cases at
tertiary care centre. Med Pulse Intl J Gynaecol 2020; 13(2): 48-52.
https://doi.org/10.26611/10121327
. Soni A, Sharma C, Verma S, Justa U, Soni PK, Verma A. A
prospective observational study of trial of labor after cesarean
in rural India. Int J Gynaecol Obstet 2015; 129(2): 156-160.
https://doi.org/10.1016/j.ijgo.2014.11.007
Khan KS, Rizvi A, Rizvi JH. Risk of uterine rupture after the
partographic 'alert' line is crossed--an additional dimension in
the quest towards safe motherhood in labour following
caesarean section. J Pak Med Assoc 1996; 46(6): 120-122.
Shaheen N, Khalil S, Iftikhar P. Prediction of successful trial of
labour in patients with a previous caesarean section. J Pak Med
Assoc 2014; 64(5): 542-545.
Liu L, Ross WT, Chu AL, Deimling TA. An updated guide to
the diagnosis and management of cesarean scar pregnancies.
Curr Opin Obstet Gynecol 2020; 32(4): 255-262.
https://doi.org/10.1097/GCO.0000000000000644
Wright A, Nassar AH, Visser G, Ramasauskaite D, Theron G;
FIGO Safe Motherhood and Newborn Health Committee. FIGO
good clinical practice paper: management of the second stage of
labor. Int J Gynaecol Obstet 2021; 152(2): 172-181.
https://doi.org/10.1002/ijgo.13552
Bonet M, Oladapo OT, Souza JP, Gülmezoglu AM. Diagnostic
accuracy of the partograph alert and action lines to predict
adverse birth outcomes: a systematic review. BJOG 2019;
(13): 1524-1533. https://doi.org/10.1111/1471-0528.15884
Sharma RK, Sharma RC, Mhapankar S, Chaterjee A, Gaur S.
Role of partogram in previous caesarian section. Intl J Med Clin
Res 2011; 2(2): 78-83.
Vlachos G, Tsikouras P, Manav B, Trypsianis G, Liberis V,
Karpathios S, et al. The effect of the use of a new type of
partogram on the cesarean section rates. J Turk Ger Gynecol
Assoc 2015; 16(3): 145-148.
https://doi.org/10.5152/jtgga.2015.15074
Khan KS, Rizvi A. The partograph in the management of labor
following cesarean section. Int J Gynaecol Obstet 1995; 50(2):
-157. https://doi.org/10.1016/0020- 7292(95)02431-b
Faranesh R, Salim R. Labor progress among women attempting
a trial of labor after cesarean. Do they have their own rules?
Acta Obstet Gynecol Scand 2011; 90(12): 1386-1392.