A Comparative Study of the Effect of Two Partographs on the Cesarean Section Rate in Women in Spontaneous Labour

In the 2010-french perinatal survey, the overall cesarean section (CS) rate during labour was 21 % and 16% to 38% in case of dystocia.

The definition of " dystocia " is traditionally based on the research led by Friedman in the 1950's on a restricted population sample. Several studies over the last years seem to indicate that the different phases of labour are longer than originally described by Friedman.

Our current hypothesis is that the application of a new definition of dystocia would enable a more appropriate management of labour.

The main purpose of this study is to show a significant decrease of the CS rate with the use of the new partograph developed by Neal and Lowe.

Secondary purposes are

• To reduce the use of oxytocin during labour without increasing maternal or neonatal morbidity;
• To decrease immediate per-operative complications and post-operative complications associated with CS

Inclusion Criteria:

Age ≥ 18 years

• Affiliation to a social security insurance
• Written consent given
• Singleton pregnancy
• Cephalic presentation
• ≥37 gestational weeks
• Spontaneous onset of labour

Exclusion Criteria:

• Previous cesarean section
• Induction of labour
• Intrauterine growth restriction
• In utero fetal death
• Congenital malformation
• Chorioamnionitis
• Placenta praevia
• Need for an emergency delivery (fetal heart rate abnormalities at admission)
• Contra-indication for vaginal delivery
• Patient under temporary guardianship, guardianship or judicial protection
• Patient included in another study which could interfere with the results of this study