Uterine Contractions' Pattern in Active Phase of Labor as a Predictor of Failure to Progress

Background: Failure to progress remains a key indication for cesarean section which caused by different factors including uterine contractions. If it is diagnosed in the primary phase of labor, a better prognosis can thus be made. The purpose of this study was to find a possible correlation between pattern of uterine contraction and progression of labor.

Method: During this study, 120 women referred for delivery to an educational hospital’s maternity ward in the North of Iran in 2010 were included. Uterine contractions of mothers were recorded in dilatation of 4 to7 cm for an hour. In this way, F/R ratio which means the time that a contraction needs to return from its peak to baseline (Fall) divided to the time for a contraction to rise to its peak (Rise) was calculated. All of the participants were followed until delivery, vaginal delivery or caesarean section.

Results: Mean and standard deviation of fall to raise ratio was 1.54± 0.26 in mothers with vaginal delivery versus 1.74± 0.21 for others underwent caesarean section (OR = 0.44, 95% CI: 0.005- 0.42, P< 0.001). Sensitivity, specificity, and predictive values (positive and negative) of mentioned ratio were 68.32%, 70.01%, 69.55%, and 68.91%, respectively.

Conclusion: By considering acceptable predictive value of uterine contractions' pattern in the active phase of labor, it could help to timely diagnosis of failure to progress and consequently suitable intervention which probably maintain better health of both mother and fetus.