Assessment of the impact of an expectant management in case of abnormally progressing first-stage labor

OBJECTIVE To compare the cesarean section rate before and after the introduction of an expectant management protocol in patients with abnormally progressing first-stage labor. METHODS A prospective monocentric cohort study performed between January 2012 and July 2016. RESULTS 267 patients were included, 97 in the control group and 170 in the study group. The number of cesarean sections decreased from 86 % to 45 % (p < 0.001). The number of instrumental extractions increased from 8.3% to 29.4% (p < 0.001). The number of postpartum hemorrhages increased from 5.2% to 18% (p < 0.01). No differences in the rates of perineal lesions, neonatal pHa below 7.10, and shoulder dystocia were observed. CONCLUSION The expectant management in patients with labor arrest in the first stage was associated with a decrease in the number of cesarean sections, at the cost of an increase in instrumental extractions and postpartum hemorrhages.