Trial of labor: A disciplined approach to labor management resulting in a high rate of vaginal delivery

F. L. Videla, Andrew Satin, W. H. Barth, G. D V Hankins

Research output: Contribution to journalArticle

Abstract

A disciplined approach to labor management has resulted in a low cesarean rate (9%) in our population. We wondered if this management scheme was applicable and safe applied to women with previous cesareans. Women with a previous cesarean delivering in a 5-year period were included. Labor management included encouragement of trial of labor, labor stimulation with oxytocin when indicated, epidural analgesia only after entering the active phase, and continuous monitoring. Demographic, labor and delivery, and neonatal data were electronically stored and analysis performed using SPSS release 4.1 for VAX/VMS. Statistical analysis was performed using chi-square and Fisher's exact test where appropriate. Multiple logistic regression was performed to control for potentially confounding variables. A previous cesarean had been performed in 713 (11%) gravidas who met the inclusion criteria. Vaginal delivery was attempted in 588 (82%) and 517 (88%) achieved vaginal birth. Older women (14 versus 1 versus 8%, p = 0.04), of higher parity (63 versus 35 versus 17%, p = 0.0001), requiring preterm delivery (14 versus 8 versus 4%) were more likely to have an elective repeat cesarean than a successful or failed trial of labor. Pregnancies requiring oxytocin (90 versus 53%, p = 0.02), receiving epidural analgesia (62 versus 49%, p = 0.05), developing chorioamnionitis (20 versus 4%, p

Original languageEnglish (US)
Pages (from-to)181-184
Number of pages4
JournalAmerican Journal of Perinatology
Volume12
Issue number3
StatePublished - 1995
Externally publishedYes

Fingerprint

Trial of Labor
Epidural Analgesia
Oxytocin
Chorioamnionitis
Confounding Factors (Epidemiology)
Parity
Logistic Models
Demography
Parturition
Pregnancy
Population

Keywords

  • cesarean section
  • labor management dystocia
  • oxytocin
  • Trial of labor

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Trial of labor : A disciplined approach to labor management resulting in a high rate of vaginal delivery. / Videla, F. L.; Satin, Andrew; Barth, W. H.; Hankins, G. D V.

In: American Journal of Perinatology, Vol. 12, No. 3, 1995, p. 181-184.

Research output: Contribution to journalArticle

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