Arrest of dilation of <4 hours was associated with decreased risks of adverse maternal outcomes, vs 4 to 5.9 hours but not primary outcome (composite neonatal risk)
There was increased risk for cesarean and chorioamnionitis (secondary maternal outcomes)
At cervical dilation was 8 or 9 cm: Arrest of dilation of <4 hours was associated with decreased risks of both adverse maternal and neonatal outcomes
Women starting at a cervical dilation of 8 cm who required <4 hours to achieve a cervical change of 1 cm had lower rates of
Adjusted odds ratio 0.40 (95% CI, 0.28 to 0.55)
Adjusted odds ratio 0.42 (95% CI, 0.29 to 0.60)
Neonatal composite outcome
Adjusted odds ratio 0.51 (95% CI, 0.36 to 0.72)
When arrest of dilation occurs at 8 or 9 cm, the benefits of allowing arrest to persist beyond 4 hours should be weighed against the increased risk of adverse neonatal and maternal outcomes
For women with arrest of dilation at 6 or 7 cm, a duration of arrest >4 hours was not associated with increased risks of adverse neonatal outcomes | Increased risk for maternal adverse outcomes may be an association vs causative and prospective studies are required
Consortium on Safe Labor data from 2002 to 2008, prior to Obstetric Care Consensus publication
The authors conclude
When cervical dilation is 6 or 7 cm, allowing arrest of dilation of ≥4 hours is reasonable because it was not associated with increased risks of adverse neonatal outcomes
When cervical dilation is 8 or 9 cm, the benefit of allowing arrest of dilation of ≥4 hours should be balanced against the risk of adverse maternal and neonatal outcomes
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan