Active Versus Traditional Management of Labor: A Prospective Randomized Study

Abstract

Objective: The aim of this study is to explore the effect of active management of labor on the course of labor, prenatal outcomes and the rate of cesarean sections.

Sitting: This study was conducted in Tripoli Medical Center from February 2005 to November 2006 and included 300 nulliparous women in spontaneous labor, at term with a singleton fetus in cephalic presentation.

Material and Methods: Active phase of labor was defined when labor pains were regular, at least 2 contractions per 10 minutes, each contraction lasts for 45 seconds or more, with cervical dilatation more than 3cm. Cases with multifetal pregnancy, preterm fetus, non cephalic presentation, cervical dilatation >8cm on admission, obvious cephalopelvic disproportion, contracted outlet, fetal congenital anomalies, estimated fetal weight 2500g, spontaneous or induced rupture of membranes before admission, maternal medical disorder with pregnancy, antepartum hemorrhage as well as mother unsure of date, were all excluded.

Randomization: Study participants were randomized to active management of labor and traditional management, each group involved 150 participants.

Result: A partogram was constructed for each case under the study to compare the prenatal outcome in both groups. The mean duration of labor was less in active management group and cesarean section rate was not significantly different from the other group.

Conclusion: Active management does not decrease the cesarean section rate, and is as good as traditional management with respect to prenatal outcome, and it also saves time and effort of the attending physician.