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Active management of labor versus expectant management in first nulliparas with a prolonged latent phase: a randomized trial

Not Applicable
Conditions
Pregnancy and Childbirth
other
Registration Number
PACTR202308714803965
Lead Sponsor
hedi cheker hospital
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Complete
Sex
Female
Target Recruitment
340
Inclusion Criteria

? Spontaneous entry into labor.
? A prolonged latent phase of labor (absence of cervical dilation beyond four centimeters after eight hours of regular uterine contractions (UC)).
? nulliparous (No previous pregnancy > 20 weeks).
? PFE between 2000 gram(g) and 4000g.
? The presence of CUs (at least 1 CU/30 min).
? Cervical dilation = 3 cm.
? Pocket of water (PDEA) intact.
? First trimester ultrasonography done.
? Pregnancy term (TG): = 37SA.
? A single, progressive pregnancy.
? Summit presentation.
? A good bony pelvis.
? Normal oscillating, normal reactive fetal heart rhythm recording (ERCF).
? Bishop score = 6.

Exclusion Criteria

? Estimated fetal weight = 4000 g or = 2000 g.
? Induction of labor
? Contraindications to vaginal delivery.
? Scar womb (history of uterine surgery).
? Presence of a history of significant disease vs. direction of labor.
? Multiparity.
? TG < 37 SA.
? Bishop score < 6.
? Presentation other than summit.
? Pathological ERCF.
? Unexplained placenta previa or metrorrhagia.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The rate of cesarean section was 35.6% in the overall population, including 27.6% in the expectant management group versus 43.5% in the active management group; p<0.001.<br>The rate of forceps delivery was 4.7% for the Expectative Management Group versus 10% for the Active Management Group; p<0.001<br>The rate of vaginal delivery without forceps was 67.6% for the Expectative Management Group versus 46.5% for the Active Management Group; p<0.001<br>
Secondary Outcome Measures
NameTimeMethod
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