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.