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Latent phase of labour – to admit or not?
  1. S Kotasthane,
  2. E Ferfuson,
  3. M McSherry
  1. Wishaw General Hospital, Glasgow, UK

Abstract

Introduction Worldwide, concern exists about the steadily increasing rates of intervention in normal labour. A multidisciplinary group at Wishaw General Hospital met to analyse the management of women in early labour, with the aim of developing guidelines to manage the latent phase.

Methods We prospectively gathered information for all pregnant women, more than 37 weeks gestation, deemed to be low-risk, attending Obstetric Triage at Wishaw General Hospital to assess whether they were in labour. Data was recorded over a 4 week period on cervical dilatation, frequency of uterine contractions, parity and how they were managed from triage. Subsequent information was gathered from computer records on the outcome of their labour.

Results Of the 184 women assessed, 106 were in active labour and transferred to labour ward. Of the remaining 78, 50% were admitted to antenatal wards and the rest discharged home. There was no difference in the parity of the two groups. Similar numbers of women required caesarean delivery in each of the two groups, but those who were sent home (when in latent phase) subsequently had higher rates of amniotomies (41% vs 21%), augmentation of labour (54% vs 28%) and instrumental delivery (23% compared with 10%).

Conclusion Women attending obstetric services in early labour were more likely to require intervention in labour if they were sent home when in the latent phase. More work is needed to assess the reasons for this and develop strategies for managing women in early labour in order to reduce these interventions.

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