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Outcome of labor among women admitted at advanced cervical dilatation

Abstract Objective: To identify in our setting the outcome of labor among women admitted at advanced cervical dilatation. Methods: This prospective cohort study was carried out between 1 December 2015 and 31 March 2016. Women carrying live term singletons in vertex presentation admitted with a cervical dilatation >5 cm (late arrival group) or ≤5 cm (early arrival group) were followed up till delivery. The main variables studied included mode of delivery, genital lacerations, and postpartum hemorrhage (PPH). Data from women in both groups were compared. Fisher’s exact test and t-test were used for comparison. p < .05 was considered statistically significant. Results: Late arrival in the labor ward was observed in 52.5% of women (126/240). Late arrival in the labor ward was significantly associated with a reduction in the cesarean section (CS) risk (Relative risk (RR) 0.34, 95%CI 0.12–0.94), but with an increased risk of lower genital tract lacerations (RR 2.3, 95%CI 1.3–3.8), PPH (RR 4.5, 95%CI 1.04–20.2), and admission of the newborn in the neonatal intensive care unit for neonatal asphyxia or infection (RR 3.6, 95%CI 1.04–12.5). Conclusion: Late arrival in the labor ward was associated with an increased risk of maternal and neonatal morbidity. Therefore, women should be encouraged to arrive early in the labor ward.