Abstract

BackgroundInterventions given to women admitted in latent or active phase of labor may influence the outcomes of labor and ameliorate complications which can affect the mother and fetus. Labour management, maternal and fetal outcomes among low risk women presenting both in latent phase and active phase of labour in Tanzania have not recently been explored.MethodsThis was a descriptive cross-sectional study. It was done from February to April 2013. Case notes were collected serially until the sample size was reached. A structured checklist was used to extract data. Data was analyzed using SPSS version 17. A p < 0.05 was considered significant at 95% confidence interval.ResultsFive hundred case notes of low risk pregnant women were collected, half of each presented in latent phase and active phase of labour. Key interventions including augmentation with oxytocin, artificial rupture of membranes and caesarean section were significantly higher in the latent phase group than the active phase group 84(33.6%) versus 52(20.8%) p < 0.05; 96(38.6%) versus 56(22.4%) p < 0.05 and 87(34.8%) versus 60(24.0%) p < 0.05 respectively. Spontaneous vertex delivery was higher among pregnant women admitted initially in active phase than in latent phase groups 180(72.0%), versus 153(61.2%) p > 0.01). There were more women in the active phase group who sustained genital tract tear and postpartum haemorrhage than in the latent phase group 101(18.6%), versus 38(15.6%) p < 0.01 and 46(18.4%), versus 17(6.6%) p < 0.05 respectively.ConclusionsPregnant women admitted at BMC in latent phase of labour are subjected to more obstetric interventions than those admitted in the active phase. There is need to produce guidelines on management of women admitted in latent phase of labour at BMC to reduce the risk of unnecessary interventions.

Highlights

  • Interventions given to women admitted in latent or active phase of labor may influence the outcomes of labor and ameliorate complications which can affect the mother and fetus

  • Evidence demonstrates that management of early labor has an impact on maternal and neonatal outcomes, in which women who are admitted in the active phase of labor at 4cms or more cervical dilatation experience less interventions and complications than those admitted in the latent phase of labor with 3cms cervical dilatation or less [4]

  • Proportion of pregnant women who received key interventions including augmentation with oxytocin, artificial rupture of membranes and caesarean section were significantly higher in the latent phase group than in the active phase group 84(33.6%) versus 52(20.8%) p < 0.05; 96 (38.6%), versus 56(22.4%) p < 0.001 and 87(34.8%), versus 60(24.0%) p < 0.05 respectively

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Summary

Introduction

Interventions given to women admitted in latent or active phase of labor may influence the outcomes of labor and ameliorate complications which can affect the mother and fetus. Evidence demonstrates that management of early labor has an impact on maternal and neonatal outcomes, in which women who are admitted in the active phase of labor at 4cms or more cervical dilatation experience less interventions and complications than those admitted in the latent phase of labor with 3cms cervical dilatation or less [4]. Delayed-admission in labor may help to avoid premature and unnecessary intervention in women with prolonged latent phase. A study done by McNiven et al showed that women who delayed admission while in labor had significant less oxytocin use compared with early admitted ones 40% versus 23%, and shorter duration of labor in hospital 13.5 hours versus 8.3 hours respectively but there was no significant differences in caesarean delivery and neonatal outcomes [5]. Prolonged latent phase is associated with a higher risk of subsequent labor abnormalities, such as postpartum hemorrhage, chorioamnionitis and neonatal admission to the intensive care unit and long hospital stay [6]

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