Rate Of Cervical Dilatation, Duration Of Active Labor And Rate Of Intervention Among Low-Risk Pregnant Women Delivering At Dodoma Regional Referral Hospital

ABSTRACT

Background: Cervical dilation at the onset of the active phase of labor determines the rate of cervical dilatation, duration of the active phase of labor and the needs of intervention. Identifying the abnormality toward the natural progress of the active phase of labor is important because timely intervention has been observed to be controversial among developing countries during the current practice among health care providers due to different opinion on the onset of the active phase. Thus, indication like poor progress of labor has been poorly explained in which it has become a common indication for a steady increased rate of primary cesarean section. Objectives: This study aimed at determining the rate of cervical dilatation, duration of active phase of labor, and rate of intervention among low-risk pregnant women delivered at Dodoma Regional Referral Hospital. Methods: This is a hospital-based prospective cross-sectional study where systematic sampling method was employed in obtaining sample of 300 pregnant women. Local partograph and a semi-structured questionnaire were used to record the information and findings. Data were analyzed using SPSS version 25. One sample t-test was used to determine the rate and duration of active labor. A Chisquare test was done to find the factors associated with intervention during labor. Furthermore, Binary logistic regression was done to obtain the odds ratio (OR) and 95% confidence intervals (CI). P< 0.05 was considered statistically significant. Results: The rate of cervical dilatation during active phase for nulliparous was 0.81 cm/hour and 0.88 cm/hour for multiparous. The duration of the active phase of labor was 7.6 hours for nulliparous and 6.8 hours for multiparous. 48(16%) women out of 300 participants had intervention during labor; with higher rate in nulliparous. Oxytocin infusion was the common intervention. Gravidity, gestation age and patient occupation were significantly associated with intervention, other factors were not associated with intervention. Conclusion: The rate of cervical dilatation was much slower hence the longer duration of active phase than the WHO standards rates. Nulliparous were mostly intervened and oxytocin was a common intervention. Occupation is associated with intervention but further research involving large sample size is recommended