Takeaway
- The authors propose that a new labour curve is needed.
Why this matters
- The Friedman curve was popularised in 1954.
- Changing demographic factors, including increasing maternal age, maternal weight, and gestational weight, have led some to question the continued applicability of the Friedman curve.
- Understanding labour kinetics can help to predict outcomes and manage interventions.
Key results
- Compared with Friedman's sigmoidal curve, this study plotted a more exponential curve.
- The time interval in the first stage of labour was longer than that in Friedman's curve.
- Both nulliparas and multiparas accelerated after 6 cm of dilation.
- Epidural anesthesia lengthened duration to second stage; for each cm left to 10 cm of dilation, time to second stage was extended by a mean of 6.14 minutes (P<.001).
- Epidural anesthesia lengthened the second stage of labour.
- Labor curves followed a similar pattern for both nulliparous and multiparous participants.
Study design
- Retrospective cohort study.
- Electronic records were used to abstract detailed labour information and demographic characteristics at one hospital between 2011 and 2016 (35,146 deliveries).
- Funding: None disclosed.
Limitations
- Only spontaneously labouring patients at term were studied.
References
References
