Association of Cervical Effacement With the Rate of Cervical Change in Labor Among Nulliparous Women. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Langen, Elizabeth S.; Weiner, Steven J.; Bloom, Steven L.; Rouse, Dwight J.; Varner, Michael W.; Reddy, Uma M.; Ramin, Susan M.; Caritis, Steve N.; Peaceman, Alan M.; Sorokin, Yoram; Sciscione, Anthony; Carpenter, Marshall W.; Mercer, Brian M.; Thorp, John M.; Malone, Fergal D.; Iams, Jay D.
• Is Part Of: Obstetrics and gynecology. Volume 127:Issue 3(2016)
• Publication Date: 2016-03
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/AOG.0000000000001299
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : OBJECTIVE: To assess the association of cervical effacement with the rate of intrapartum cervical change among nulliparous women. METHODS: We conducted a secondary analysis of a prospective trial of intrapartum fetal pulse oximetry. For women who had vaginal deliveries, interval-censored regression was used to estimate the time to dilate at 1-cm intervals. For each given centimeter of progressive cervical dilation, women were divided into those who had achieved 100% cervical effacement and those who had not. The analysis was performed separately for women in spontaneous labor and those who were given oxytocin. RESULTS: A total of 3, 902 women were included in this analysis, 1, 466 (38%) who underwent labor induction, 1, 948 (50%) who underwent labor augmentation (combined for the analysis), and 488 (13%) who labored spontaneously. For women in spontaneous labor, the time to dilate 1 cm was shorter for those who were 100% effaced starting at 4 cm of cervical dilation ( P =.01 to <.001). For women who received oxytocin, the time to dilate 1 cm was shorter for those who were 100% effaced throughout labor ( P <.001). CONCLUSION: The rate of cervical dilation among nulliparous women is associated with not only the degree of cervical dilation, but also with cervical effacement. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00098709. Abstract : Supplemental Digital Content is Available in the Text.Achievement of 100% cervical effacement is associated with a shorter median time of dilation among nulliparous women.