Active labor management and its relationship with maternal and perinatal morbility
DOI:
https://doi.org/10.18597/rcog.599Keywords:
active labor, caesarean, dystociaAbstract
Active labor management seems to be a worth while option to obtain good results in the attention of obstetrical patients. It is defined as the process in which obstetrician takes an active roll, conduct, and accompany the obstetric patient during labor.
The principal requirement to enter the patient in the active handling is that the patient is in true labor, in the initial or advanced phase.
The components of the active management of labor are:
1. Minimal requirements for patient inclusion: beginning of labor (3 contractions in 10 minutes) and/or 3 cm minimum of cervical dilation.
2. Obstetrical analgesia.
3. Early membrane rupture, as long as the true labor had started.
4. Suitable doses of oxytocin, that conserves the physiologic contractility rhythm.
5. Strict monitoring of the patient and fetus.1, 2
The active handling of labor has demonstrated its benefits in the perinatal and maternal outcomes. The objective of this review is to show the results obtained with active management of labor in a group of patients of a third level obstetrical attention center.
A retrospective, descriptive investigation was done using chart review of 405 patients who delivered at the clinic El Rosario during the one-year period, from August 2001 to August 2002, and that fulfilled the inclusion criteria defined before.
From all the patients included, 77% were between 18 and 35 years of age, 45% were in the first delivery. Hemorrhagic complications appeared on 1,4% of the patients, and 24,3% of the deliveries were cesarean sections. Labor was shorter than 6 hours in 84,6% of the patients. The findings presented may constitute evidence supporting further prospective research to evaluate the impact of active labor management in the obstetrical patient.
Author Biographies
Luis Guillermo Echavarría Restrepo
María Nazareth Campo Campo
Ana Cecilia Gómez Mejía
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