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Evidence-Based Medicine 2007;12:46; doi:10.1136/ebm.12.2.46
Copyright © 2007 by the BMJ Publishing Group Ltd.
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Therapeutics

Use of a 2 hour partogram action line instead of a 4 hour action line did not reduce caesarean delivery rate

Lavender T, Alfirevic Z, Walkinshaw S. Effect of different partogram action lines on birth outcomes: a randomized controlled trial. Obstet Gynecol 2006;108:295–302.[Abstract/Free Full Text]

Q In primiparous women in spontaneous labour at term, does the use of a 2 hour partogram action line reduce the risk of caesarean delivery compared with a 4 hour action line?

Clinical impact ratings Obstetrics ******* GP/FP/Obstetrics ******{star}

Key Words: delivery (obstetric) • labour (obstetric) • uterine monitoring

The first 150 words of the full text of this article appear below.

METHODS
Formula Design: randomised controlled trial.

Formula Allocation: concealed.*

Formula Blinding: unblinded.*

Formula Follow up period: 2–10 days after delivery.

Formula Setting: midwife led unit and physician led delivery suite in a teaching hospital in northwest England, UK.

Formula Patients: 3000 primigravid women (mean age 25 y) in spontaneous labour at term with an uncomplicated singleton pregnancy in cephalic presentation.

Formula Intervention: progress of labour was recorded on a partogram with an action line drawn either 2 hours (n = 1503) or 4 hours (n = 1497) after the alert line. If the plot of cervical dilatation against time crossed the action line, delivery suite guidelines for the management of prolonged labour were followed.

Formula Outcomes: caesarean delivery, need for augmentation of labour, duration of labour, use of epidural analgesia, postpartum haemorrhage, number of vaginal examinations, admission of the infant to the neonatal intensive care unit (NICU), and Apgar score. The study had 90% power to detect a 3% . . . [Full text of this article]

Charissa Fotinos, MD

University of Washington, Seattle, Washington, USA


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Other articles noted
Evid. Based Med. 2007 12: 63-64. (in ) [Extract] [Full Text] [PDF]





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