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New Labor Management Guidelines and Changes in Cesarean Delivery Patterns

Rosenbloom, J.I.; Stout, M.J.; Tuuli, M.G.; Woolfolk, C.L.; López, J.D.; Macones, G.A.; Cahill, A.G.

doi: 10.1097/01.aoa.0000542494.71010.c7
Mother, Fetus, Neonate

(Am J Obstet Gynecol 2017;217:689.e1–e8)

In 2010 the Consortium on Safe Labor published new labor curves based on contemporary parturients which changed the onset of active labor to 6 cm. The American College of Obstetricians and Society for Maternal-Fetal Medicine proposed that the cesarean delivery (CD) rate could be lowered by avoiding the diagnosis of arrest of dilation before 6 cm. However, the efficacy of the new labor curves, the extent of their clinical implementation, and their effect on CD rates is still unclear. This study was aimed at testing the following hypotheses: (1) rates of arrest of dilation disorders have decreased in term, low-risk patients and (2) pushing duration before the diagnosis of arrest of descent has increased. In turn, a decrease in CD rates should be observed. Changes in the maternal and neonatal morbidity were also investigated.

Department of Obstetrics and Gynecology, Washington University in St Louis School of Medicine, St Louis, MO

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