FACTORS THAT INFLUENCE ROUTE OF DELIVERY - ACTIVE VERSUS TRADITIONAL LABOR-MANAGEMENT

OBJECTIVE: Our purpose was to compare maternal and fetal factors that influence the route of delivery with active management of labor and a traditional labor management protocol. STUDY DESIGN: Data were collect ed prospectively on 346 consecutive patients receiving active manageme nt of labor and 354 patients who were managed traditionally. Within ea ch group demographic and labor characteristics of patients undergoing cesarean section were compared with those of patients having vaginal d eliveries by means of the Student t test, chi2 analysis, and stepwise logistic regression. RESULTS: With both active management of labor and traditional labor management success in achieving vaginal delivery wa s related to the station of the fetal vertex at admission, the need fo r oxytocin augmentation of labor, the uterine response to oxytocin, th e use of epidural anesthesia, and the development of chorioamnionitis. By means of multiple logistic regression analysis maternal age, heigh t, payor status, and birth weight were also identified as risk factors for cesarean section with traditional labor management but not with a ctive management of labor CONCLUSIONS: Differences were identified in risk factors for cesarean section between active management and tradit ional labor management. Active management of labor may diminish or eli minate some patient characteristics as risk factors for cesarean birth .