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

Authors

  • Salisa Khan Department of Obstetrics & Gynaecology, Pak Emirates Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Tehreem Yazdan Department of Obstetrics & Gynaecology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Mahpara Tariq Department of Obstetrics & Gynaecology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Shakila Parveen Department of Obstetrics & Gynaecology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan.
  • Rizwana Bashir Department of Obstetrics & Gynaecology, Pak Emirates Military Hospital /National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Mehwish Munir Department of Obstetrics & Gynaecology, Pak Emirates Military Hospital /National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i1.9511

Keywords:

Caesarean section, Parity, Gravidity, Labor Pain, Fetal monitoring, Trial of labor, Catheterization, Uterine monitoring

Abstract

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.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

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.

https://doi.org/10.1111/j.1600-0412.2011.01263.

Downloads

Published

28-02-2024

How to Cite

Khan, S., Tehreem Yazdan, Mahpara Tariq, Shakila Parveen, Bashir, R., & Mehwish Munir. (2024). 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. Pakistan Armed Forces Medical Journal, 74(1), 179–182. https://doi.org/10.51253/pafmj.v74i1.9511

Issue

Section

Original Articles