Rate of cervical dilatation in primigravidae with spontaneous vertex delivery: Does speed matter?

The use of the partogram is widely recommended in order to improve the maternal and fetal outcomes. It is, however, yet not definitely established how to interpret the meaning of the alert and action lines. This is a retrospective study of 629 partograms of primigravidae who had a spontaneous vaginal delivery after expectant management of labour. The alert line, defined by a dilatation rate of 1 cm/hr, was crossed by 33.2% of the patients.Twenty-nine patients (4.6%) crossed the action line, set parallel and 4 hrs to the right of the alert line. The fresh stillbirth rate was 2/629 (0.32%). There was one early neonatal death. Resuscitation, indicated when at least one of the Apgar score values was < 7, was needed in 19/629 (3.0%). Only one of the resuscitated newborns was born to a mother who crossed the action line. Our findings suggest that the benefits resulting from the use of the partogram are attributable to a better monitoring of labour rather than to the speed of cervical dilatation.

Keywords: cervical dilatation, primigravidae, labour, partogram