Association of Cervical Effacement With the Rate of Cervical Change in Labor Among Nulliparous Women

作者：Langen Elizabeth S^*; Weiner Steven J; Bloom Steven L; Rouse Dwight J; Varner Michael W; Reddy Uma M; Ramin Susan M; Caritis Steve N; Peaceman Alan M; Sorokin Yoram; Sciscione Anthony; Carpenter Marshall W; Mercer Brian M; Thorp John M Jr; Malone Fergal D; Iams Jay D

来源：Obstetrics and Gynecology, 2016, 127(3): 489-495.

DOI：10.1097/AOG.0000000000001299

OBJECTIVE:
To assess the association of cervical effacement with the rate of intrapartum cervical change among nulliparous women.
METHODS:
We conducted a secondary analysis of a prospective trial of intrapartum fetal pulse oximetry. For women who had vaginal deliveries, interval-censored regression was used to estimate the time to dilate at 1-cm intervals. For each given centimeter of progressive cervical dilation, women were divided into those who had achieved 100% cervical effacement and those who had not. The analysis was performed separately for women in spontaneous labor and those who were given oxytocin.
RESULTS:
A total of 3,902 women were included in this analysis, 1,466 (38%) who underwent labor induction, 1,948 (50%) who underwent labor augmentation (combined for the analysis), and 488 (13%) who labored spontaneously. For women in spontaneous labor, the time to dilate 1 cm was shorter for those who were 100% effaced starting at 4 cm of cervical dilation (P=.01 to <.001). For women who received oxytocin, the time to dilate 1 cm was shorter for those who were 100% effaced throughout labor (P<.001).
CONCLUSION:
The rate of cervical dilation among nulliparous women is associated with not only the degree of cervical dilation, but also with cervical effacement.
CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov,
[GRAPHICS]
, NCT00098709.

• 出版日期2016-3
• 单位西北大学