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Is Cystocele a Risk Factor For Prolonged Active Phase of Labour in Grand Multipar Pregnancies?

Year 2014, Volume: 11 Issue: 4, 113 - 115, 01.10.2014

Abstract

Aim: To investigate the influence of pelvic relaxation on active phase of labor in Grand multiparous women.Material and Methods: A total of 176 women were included in the study. Forty-three of these had stage 3 cystocele Group-1 , 12 had stage 3 rectocele Group-2 and 121 had minimal pelvic relaxation/stage 1 cystorectocele Group-3 . All of the study subjects had vaginal birth after 37 gestational weeks. Maternal characteristics age, gravidity, parity, body weight, hemoglobin level , fetal birth weights, durations of active phase of labor were compared between the study groups.Results: There were no significant differenc es in terms of maternal characteristics and fetal birth weight between the study groups Table I p>0.05 . Mean active phase duration was significantly longer in Group-1 when compared to Group-3 7.5±2.4 hours vs. 5.2±1.98 hours, respectively. p=0.01 . There were no significant differences between Group-2 and Group-3 5.4±1.92 vs. 5.2±1.98 hours, respectively. p>0.05 .Conclusion: Active phase of labor was significantly longer in grand multiparous women with stage-3 cystocele. This difference may be associated with protracted labor in these women. The effect of pelvic relaxation on active phase of labor duration should be considered before proceeding to cesarean section for labor dystocia.

References

  • 1. Friedman E. The graphic analysis of labor. Am J Obstet Gynecol 1954; 68: 1568-75.
  • 2. Friedman EA. Primi gravid labor: a graphico statistic alanalysis. Obstet Gynecol 1955; 6: 567-89.
  • 3. American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics: ACOG practice bulletin, Number 49, December 2003: Dystocia and augmentation of labor. Obstet Gynecol 2003;102: 1445-1454
  • 4. Zhang J, Troendle J, Mikolajczyk R, Sundaram R, Beaver J, Fraser W: The natural history of the normal first stage of labor. Obstet Gynecol 2010;115: 705-710
  • 5. Bugg GJ, Siddiqui F, Thornton JG: Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour. Cochrane Database Syst Rev 2011; 6: CD007123
  • 6. Mancuso MS, Rouse DJ. Cesarean delivery for abnormal labor.ClinPerinatol. 2008; 35: 479-90
  • 7. Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 2000; 183: 277–285.
  • 8. Mouritsen L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14: 122–127.
  • 9. Roman H, Robillard PY, Verspyck E, Hulsey TC, Marpeau L, Barau G. Obstetric and neonatal outcomes in grand multiparity. Obstet Gynecol. 2004;103: 1294
  • 10. Incerti M, Locatelli A, Ghidini A, Ciriello E, Malberti S, Consonni S, Pezzullo JC. Prediction of duration of active labor in nulliparous women at term. Am J Perinatol. 2008; 25: 85–9.
  • 11. Müge Harma, Mehmet Harma, Şeniz Yurtseven, Nurettin Demir. Frequency of Anemıa Among Multıparous Pregnant Women. Turkiye Klinikleri J Gynecol Obst 2004;14: 12-5.
  • 12. Bailit JL, Dierker L, Blanchard MH, Mercer BM. Outcomes of women presenting in active versus latent phase of spontaneous labor. Obstet Gynecol. 2005; 105: 77–9.
  • 13. Gross MM, Hecker H, Matterne A, Guenter HH, Keirse MJ. Does the way that women experience the onset of labou rinfluence the duration of labour? BJOG. 2006; 113: 289–94.
  • 14. Zhang J, Troendle JF, Yancey MK: Reassessing the labor curve in nulliparous women. Am J Obstet Gynecol 2002; 187: 824-828.
  • 15. Harper LM, Caughey AB, Roehl KA, Odibo AO, Cahill AG. Defining an abnormal first stage of labor based on maternal and neonatal outcomes. Am J Obstet Gynecol. 2013;19 9378.
  • 16. İncim Bezircioğlu, Nilgün Yapan Göral, Ali Baloğlu, Yurdaer Baydar. Grand multiparitenin Maternal, Obstetrik, Fetal Ve Neonatal Sonuçlara Etkisi. Perinatoloji Dergisi 2013;21: 17-22.
  • 17. Gifford DS, Morton SC, Fiske M, Keesey J, Keeler E, Kahn KL. Lack of progress in labor as a reason for cesarean. Obstet Gynecol 2000;95: 589–95.
  • 18. Decarle DW. Dystocia due to softtissue. Calif Med. 1954;81: 206-9.

Sistosel Grand Multipar Gebelerde Doğumun Aktif Faz Süresini Uzatan Bir Risk Faktörü müdür?

Year 2014, Volume: 11 Issue: 4, 113 - 115, 01.10.2014

Abstract

Amaç: Çalışmanın amacı grand multipar gebelerde mevcut olan pelvik relaksasyonun aktif eylem süresine etkisinin incelenmesidir.Gereç ve Yöntemler: Çalışmaya 176 grand multipar gebe dahil edilmiş olup; 43 gebe evre 3 sistoseli olan Grup 1 , 12 gebe evre 3 rektoseli olan Grup 2 ve 121 gebe ise minimal pelvik relaksasyon/ evre 1 sistorektoseli olan kontrol grubu Grup 3 olarak sınıflandırılmıştır. Çalışmadaki tüm gebelerin doğumları vajinal yolla olup 37 hafta ve üzerinde gerçekleşmiştir. Gruplar maternal karakteristikler yaş, gravida, parite, maternal ağırlık, maternal hemoglobin seviyesi , fetüsün doğum ağırlığı, doğumun aktif faz süreleri açısından karşılaştırılmıştır.Bulgular: Gruplar arasında maternal karakteristikler maternal yaş, gravida, parite, kilo, maternal hemoglobin ve bebeklerin doğum kiloları açısından anlamlı fark tespit edilmedi p>0.05 . Aktif eylem sürelerinde ise evre-3 sistoseli olan grup 1 ile kontrol grubu olan grup 3 kıyaslandığında sürenin anlamlı olarak arttığı izlendi 7.5±2.4 saat ve 5.2±1.98 saat p=0.01 . evre-3 rektoseli olan grup 2 ile grup 3 karşılaştırıldığında ise süreler arasında anlamlı fark bulunmadı 5.4±1.92 saat ve 5.2±1.98 saat. p>0.05 .Sonuç: Sistoseli olan grand multipar hastalarda aktif eylem süresi beklenenden uzun olarak saptanmıştır. Bu sürenin normalden fazla olması bu hastalarda ilerlemeyen eylemi düşündürebilir. Sezaryen kararı alınmadan önce, pelvik relaksasyonun doğumun aktif faz süresine etkisi göz önüne alınmalıdır.

References

  • 1. Friedman E. The graphic analysis of labor. Am J Obstet Gynecol 1954; 68: 1568-75.
  • 2. Friedman EA. Primi gravid labor: a graphico statistic alanalysis. Obstet Gynecol 1955; 6: 567-89.
  • 3. American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics: ACOG practice bulletin, Number 49, December 2003: Dystocia and augmentation of labor. Obstet Gynecol 2003;102: 1445-1454
  • 4. Zhang J, Troendle J, Mikolajczyk R, Sundaram R, Beaver J, Fraser W: The natural history of the normal first stage of labor. Obstet Gynecol 2010;115: 705-710
  • 5. Bugg GJ, Siddiqui F, Thornton JG: Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour. Cochrane Database Syst Rev 2011; 6: CD007123
  • 6. Mancuso MS, Rouse DJ. Cesarean delivery for abnormal labor.ClinPerinatol. 2008; 35: 479-90
  • 7. Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 2000; 183: 277–285.
  • 8. Mouritsen L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14: 122–127.
  • 9. Roman H, Robillard PY, Verspyck E, Hulsey TC, Marpeau L, Barau G. Obstetric and neonatal outcomes in grand multiparity. Obstet Gynecol. 2004;103: 1294
  • 10. Incerti M, Locatelli A, Ghidini A, Ciriello E, Malberti S, Consonni S, Pezzullo JC. Prediction of duration of active labor in nulliparous women at term. Am J Perinatol. 2008; 25: 85–9.
  • 11. Müge Harma, Mehmet Harma, Şeniz Yurtseven, Nurettin Demir. Frequency of Anemıa Among Multıparous Pregnant Women. Turkiye Klinikleri J Gynecol Obst 2004;14: 12-5.
  • 12. Bailit JL, Dierker L, Blanchard MH, Mercer BM. Outcomes of women presenting in active versus latent phase of spontaneous labor. Obstet Gynecol. 2005; 105: 77–9.
  • 13. Gross MM, Hecker H, Matterne A, Guenter HH, Keirse MJ. Does the way that women experience the onset of labou rinfluence the duration of labour? BJOG. 2006; 113: 289–94.
  • 14. Zhang J, Troendle JF, Yancey MK: Reassessing the labor curve in nulliparous women. Am J Obstet Gynecol 2002; 187: 824-828.
  • 15. Harper LM, Caughey AB, Roehl KA, Odibo AO, Cahill AG. Defining an abnormal first stage of labor based on maternal and neonatal outcomes. Am J Obstet Gynecol. 2013;19 9378.
  • 16. İncim Bezircioğlu, Nilgün Yapan Göral, Ali Baloğlu, Yurdaer Baydar. Grand multiparitenin Maternal, Obstetrik, Fetal Ve Neonatal Sonuçlara Etkisi. Perinatoloji Dergisi 2013;21: 17-22.
  • 17. Gifford DS, Morton SC, Fiske M, Keesey J, Keeler E, Kahn KL. Lack of progress in labor as a reason for cesarean. Obstet Gynecol 2000;95: 589–95.
  • 18. Decarle DW. Dystocia due to softtissue. Calif Med. 1954;81: 206-9.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Kerem Doğa Seçkin This is me

Eralp Başer This is me

Mahmut İlkin Yeral This is me

Emre Özgü This is me

Murat Öz This is me

Publication Date October 1, 2014
Published in Issue Year 2014 Volume: 11 Issue: 4

Cite

Vancouver Seçkin KD, Başer E, Yeral Mİ, Özgü E, Öz M. Sistosel Grand Multipar Gebelerde Doğumun Aktif Faz Süresini Uzatan Bir Risk Faktörü müdür?. JGON. 2014;11(4):113-5.