Cervix dilation impact on birth outcomes

Aim: to evaluate cervix dilation impact on birth outcomes on nulliparous. Objectives: 1. To determine cervix characteristics related to increasing need for the epidural analgesia and labor induction. 2. To determine cervix characteristics in which labor inducting procedures (amniotomy and oxytocin) are the most effective. 3. To determine birth outcomes differences between induced and non-induced women. Methods: a retrospective study. Object: women who gave birth in the hospital of Lithuanian University of Health Sciences Kauno Klinikos (LUHS KK), Obstetrics department in years 2016 – 2017. A study included medical records of 512 pregnant women. Records were divided into two groups: group 1 - women who gave birth without labor induction, group 2 – women to whom amniotomy and/or oxytocin infusion were performed. The results: Women who came to the hospital with less than 5 cm cervix dilation or cervix effacement have a higher risk to be induced. In addition, epidural analgesia in this group was used more often (p<0,001). Group 2 has higher rate of cesarean section (CS) (15,2% versus 3,4%, p<0,001) and instrumental birth (2,7% versus 0,6%, p<0,001). Labor inducting procedures are most effective (showing the lowest CS rate) when are performed having 5 cm or more cervix dilation. First and second delivery periods and waterless period are longer in group 2 (p<0,001). Results have shown none significant differences in newborns clinical condition, meaning that it does not have an impact on newborns. Conclusions: 1. Rate of epidural analgesia and risk of labor induction is higher for women who came to the hospital with less than 5 cm cervix dilation or cervix effacement (p<0,001). 2. Labor inducting procedures are the most effective performed while cervix dilatation is 5 cm or more. 3. CS and instrumental birth rate are 5 times higher in the group of induced women (p