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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

https://doi.org/10.1136/ebm.12.2.46

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    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.
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 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 ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    unblinded.*

    Embedded ImageFollow up period:

    2–10 days after delivery.

    Embedded ImageSetting:

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

    Embedded ImagePatients:

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

    Embedded ImageIntervention:

    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.

    Embedded ImageOutcomes:

    caesarean delivery, need for augmentation …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr T Lavender, University of Central Lancashire, Preston, UK. Tinalav{at}yahoo.co.uk

    • Source of funding: Liverpool Women’s Foundation Trust.

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2007; 12 63-64 Published Online First: 30 Mar 2007. doi: 10.1136/ebm.12.2.63
    • Glossary
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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2007; 12 63-63 Published Online First: 30 Mar 2007. doi: 10.1136/ebm.12.2.63-a