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Study the rate of progress of labor among nulliparous women belonging to different body mass index groups, & observe how does this variation in maternal body mass index may affect the course of labor.
For nulliparous cases presenting to the labor ward, maternal height & weight will be collected at the time of admission to calculate the BMI (body mass index) & further classified according to WHO (World Health Organization) categories. Putting into consideration the physiological increase in BMI related to pregnancy, the overweight participants whose BMI (25-29.9) will be combined with the normal range BMI (18.5-24.9) category. Labor characteristics of these participants will be then compared with those of the underweight (BMI less than 18.5) & obese (BMI 30 or higher) participants.Females are assigned in one of 3 groups based on their BMI; Underweight group (BMI <18.5kg/m2), Control group whose BMI within normal range (18.5-29.9 kg/m2),& Obese group (BMI more than or equal 30kg/m2).
Labor management protocols are fixed. Data on labor progression are collected, including cervical dilatation, cervical effacement, head station & descent. The median duration of labor , estimated by rate of cervical dilatation in cm, will be used as a measurement of labor progression in each group.
A cesarean section for abnormal labor pattern will be documented as failure of progress.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Underweight participants whose body mass index is less than 18.5 kg/m2 | ||
| Group B | Control group, in which the participants belong to the normal body mass index range , from 18.5 to 29.9 kg/m2 | ||
| Group C | Obese participants whose body mass index is more than or equal to 30 kg/m2. |
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| Measure | Description | Time Frame |
|---|---|---|
| rate of cervical dilatation | in centimeters | every 2 hours during active phase of labor, from admission to the labor ward until second stage of labor. |
| Measure | Description | Time Frame |
|---|---|---|
| descent of fetal head | head station | every 2 hours during active phase of labor, from admission to the labor ward until second stage of labor |
| Measure | Description | Time Frame |
|---|---|---|
| duration of active phase of labor | total duration in hours | all through the course of labor, individually assessed for each participant, starting from the time of admission to labor ward until start of second stage of labor |
| duration of second stage of labor |
Inclusion Criteria:
Full term pregnancy, singleton, viable fetus, cephalic (vertex) presentation, occipito-anterior position.
Exclusion Criteria:
Induction of labor by oxytocin or prostaglandins. Conditions requiring urgent delivery eg antepartum haemorrhage, fetal distress, cord prolapse.
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pregnant nulliparous women, at term, during labor
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| Name | Affiliation | Role |
|---|---|---|
| Doaa Sh Belal, hospital | Cairo University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Cairo | Greater Cairo | 11956 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28886213 | Derived | Maged AM, Belal DS, Marie HM, Rashwan H, Abdelaziz S, Gabr AA, Elzayat AR. Prospective study of the effect of maternal body mass index on labor progress in nulliparous women in Egypt. Int J Gynaecol Obstet. 2017 Dec;139(3):329-335. doi: 10.1002/ijgo.12322. Epub 2017 Oct 3. |
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total duration in minutes
| from start of second stage of labor ( full cervical dilatation) until delivery of fetus |
| mode of delivery | vaginal delivery or cesarean section | labor |