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dc.contributor.authorGunnarsson, Bjørn
dc.contributor.authorSkogvoll, Eirik
dc.contributor.authorJónsdóttir, Ingibjörg H.
dc.contributor.authorRøislien, Jo
dc.contributor.authorSmarason, Alexander K
dc.date.accessioned2018-08-31T09:25:25Z
dc.date.available2018-08-31T09:25:25Z
dc.date.created2017-08-04T14:00:09Z
dc.date.issued2017-06
dc.identifier.citationGunnarson, B. et al. (2017) On predicting time to completion for the first stage of spontaneous labor at term in multiparous women. BMC Pregnancy and Childbirth. 17:183nb_NO
dc.identifier.issn1471-2393
dc.identifier.urihttp://hdl.handle.net/11250/2560245
dc.description.abstractBackground Labor that progresses faster than anticipated may lead to unplanned out-of-hospital births. With the aim to improve planning of transportation to birthing institutions, this study investigated predictors of time to completion for the first stage of labor conditional on cervical opening (conditional time) in multiparous women at term. Methods We performed a retrospective analysis of partograms for women in Robson’s group 3 who delivered at one hospital from 2003 to 2013. A generalized additive mixed model was fitted, accounting for possible non-linear relationships between the predictor variables and outcome, e.g. the time from each cervical measurement to full dilation, using multiple measurements for each woman. The following predictors were included: cervical dilation (cm), parity (1, 2, or ≥3 previous vaginal births), oxytocin infusion (no/yes), epidural (no/yes), maternal age (years), maternal height (cm), body mass index (BMI, kg/m2), birthweight (kg), spontaneous rupture of membranes (no/yes). A modified regression model with gestational age (days) instead of birthweight was used to predict conditional time to full cervical dilation for combinations of the most relevant predictors. Results A total of 1753 partograms were included in the analysis. The strongest predictors were birthweight, epidural and oxytocin use, and spontaneous rupture of membranes, along with cervical measurements. For birthweight, there was an almost 40% increase in time to full cervical dilation for each 1-kg increment. Conditional time was on average 23% longer in cases with epidural use and 53% longer in cases requiring oxytocin augmentation. Spontaneous rupture of the membranes shortened conditional time by 31%. Maternal age was not associated with the outcome, while increasing BMI and parity modestly reduced conditional time. Conclusions Higher parity, lower fetal weight (gestational age), and spontaneous rupture of the membranes are associated with more rapid labor.nb_NO
dc.language.isoengnb_NO
dc.publisherBioMed Centralnb_NO
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.subjectgynekologinb_NO
dc.subjectobstetrikknb_NO
dc.subjectsvangerskapnb_NO
dc.subjectpreganancynb_NO
dc.subjectbirthnb_NO
dc.subjectfødselnb_NO
dc.subjectbirthweightnb_NO
dc.subjectBMInb_NO
dc.subjectKMInb_NO
dc.subjectfødselsvektnb_NO
dc.subjectspontaneous labornb_NO
dc.titleOn predicting time to completion for the first stage of spontaneous labor at term in multiparous womennb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionpublishedVersionnb_NO
dc.rights.holder© The Author(s). 2017nb_NO
dc.subject.nsiVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756nb_NO
dc.source.pagenumber1-8nb_NO
dc.source.volume17nb_NO
dc.source.journalBMC Pregnancy and Childbirthnb_NO
dc.identifier.doi10.1186/s12884-017-1345-1
dc.identifier.cristin1484252
cristin.unitcode217,13,0,0
cristin.unitnameDet helsevitenskapelige fakultet
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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