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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Diagnosing onset of labor: a systematic review of definitions in the research literature

Authors: Gillian E. Hanley, Sarah Munro, Devon Greyson, Mechthild M. Gross, Vanora Hundley, Helen Spiby, Patricia A. Janssen

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

The diagnosis of labor onset has been described as one of the most important judgments in maternity care. There is compelling evidence that the duration of both latent and active phase labor are clinically important and require consistent approaches to measurement. In order to measure the duration of labor phases systematically, we need standard definitions of their onset. We reviewed the literature to examine definitions of labor onset and the evidentiary basis provided for these definitions.

Methods

Five electronic databases were searched using predefined search terms. We included English, French and German language studies published between January 1978 and March 2014 defining the onset of latent labor and/or active labor in a population of healthy women with term births. Studies focusing exclusively on induced labor were excluded.

Results

We included 62 studies. Four ‘types’ of labor onset were defined: latent phase, active phase, first stage and unspecified. Labor onset was most commonly defined through the presence of regular painful contractions (71 % of studies) and/or some measure of cervical dilatation (68 % of studies). However, there was considerable discrepancy about what constituted onset of labor even within ‘type’ of labor onset. The majority of studies did not provide evidentiary support for their choice of definition of labor onset.

Conclusions

There is little consensus regarding definitions of labor onset in the research literature. In order to avoid misdiagnosis of the onset of labor and identify departures from normal labor trajectories, a consistent and measurable definition of labor onset for each phase and stage is essential. In choosing standard definitions, the consequences of their use on rates of maternal and fetal morbidity must also be examined.
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Metadata
Title
Diagnosing onset of labor: a systematic review of definitions in the research literature
Authors
Gillian E. Hanley
Sarah Munro
Devon Greyson
Mechthild M. Gross
Vanora Hundley
Helen Spiby
Patricia A. Janssen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0857-4

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