Advertisement

Precipitate labor: higher rates of maternal complications

  • Eyal Sheiner
    Correspondence
    Corresponding author. Tel.: +972-8-6400774; fax: +972-8-6275338.
    Affiliations
    Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel
    Search for articles by this author
  • Amalia Levy
    Affiliations
    Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel
    Search for articles by this author
  • Moshe Mazor
    Affiliations
    Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel
    Search for articles by this author

      Abstract

      Objective: The study was aimed to identify risk factors and to elucidate pregnancy outcome following precipitate labor, i.e. expulsion of the fetus within less than 3 h of commencement of contractions. Methods: A comparison of patients with and without precipitate labor, delivered during the years 1988–2002, was conducted. Patients who underwent cesarean deliveries were excluded from the analysis. A multiple logistic regression model, with backward elimination, was performed to investigate independent risk factors for precipitate labor. Results: The number of vaginal deliveries that occurred during the study period was 137,171. Of these, 99 were precipitate. Independent risk factors for precipitate labor, using a backward, stepwise multivariate analysis were: placental abruption (odds ratio (OR)=30.9, 95% confidence interval (CI) 15.9–60.4, P<0.001); fertility treatments (OR=3.9, 95% CI 1.7–9.0, P=0.002); chronic hypertension (OR=3.1, 95% CI 1.2–7.8, P=0.015); intrauterine growth restriction (IUGR) (OR=2.9, 95% CI 1.2–6.8, P=0.014); prostaglandin E2 induction (OR=1.9, 95% CI 1.1–3.5, P=0.045); birth weight < 2500 g (OR=1.8, 95% CI 1.1–3.1, P=0.020); and nulliparity (OR=1.7, 95% CI 1.1–2.6, P=0.014). No significant differences were noted between the groups regarding perinatal complications such as meconium stained amniotic fluid, perinatal mortality and low Apgar scores. However, there were higher rates of maternal complications in the precipitate labor group such as cervical tears and grade 3 perineal tears (18.2% versus 0.3%, P<0.001; and 2.0% versus 0.1%, P<0.001, respectively), post-partum hemorrhage (13.1% versus 0.4%, P<0.001); retained placenta (2.0% versus 0.5%, P=0.02); the need for revision of uterine cavity and packed-cells transfusions (34.3% versus 4.9%, P<0.001; and 11.1% versus 1.1%, P<0.001, respectively) and prolonged hospitalization (27.6% versus 19.2%, P=0.035) as compared to the controls. Conclusion: Precipitate labor is associated with higher rates of maternal complications.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

      1. Dystocia, abnormal labor and fetopelvic disproportion. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD, editors. Williams obstetrics. 21st ed. McGraw-Hill; 2001: p. 425–50.

        • Mahon T.R
        • Chazotte C
        • Cohen W.R
        Short labor: characteristics and outcome.
        Obstet. Gynecol. 1994; 84: 47-51
      2. ACOG Practice Bulletin. Diagnosis and management of pre-eclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. ACOG Committee on Obstetric Practice. Int J Gynaecol Obstet 2002;77:67–75.

      3. ACOG Practice Bulletin. Chronic hypertension in pregnancy. American College of Obstetricians and Gynecologists. ACOG Committee on Practice Bulletins. Obstet Gynecol 2001;98:(suppl):177–85.

      4. ACOG Practice Bulletin. Gestational diabetes. Number 30, September 2001. American College of Obstetricians and Gynecologists. ACOG Committee on Practice Bulletins. Obstet Gynecol 2001;98:525–38.

        • Sheiner E
        • Shoham-Vardi I
        • Hadar A
        • Hallak M
        • Hackmon R
        • Mazor M
        Incidence, obstetric risk factors and pregnancy outcome of pre-term placental abruption: a retrospective analysis.
        J. Matern. Fetal Neonatal Med. 2002; 11: 34-39
        • Sheiner E
        • Shoham-Vardi I
        • Hallak M
        • Hadar A
        • Gortzak-Uzan L
        • Katz M
        • et al.
        Placental abruption in term pregnancies: clinical significance and obstetric risk factors.
        J. Matern. Fetal Neonatal Med. 2003; 13: 45-49
      5. Alfirevic Z. Oral misoprostol for induction of labour. Cochrane Database Syst Rev 2000;(4):CD001338.

        • Katz V.L
        • Farmer R.M
        • Dean C.A
        • Carpenter M.E
        Use of misoprostol for cervical ripening.
        South Med. J. 2000; 93: 881-884
        • Hsieh Y.Y
        • Tsai H.D
        • Chang C.C
        • Yeh L.S
        • Yang T.C
        • Hsu T.Y
        Precipitate delivery and post-partum hemorrage after term induction with 200 micrograms misoprostol.
        Zhonghua Yi Xue Za Zhi. 2000; 63: 58-61