Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term

摘要: For a baby to be born, the mother's cervix needs change from being closed open about 10 centimetres (‘dilated’). Vaginal examinations provide information on how widely dilated is, much it has thinned and position of presenting part in pelvis. This is assessing woman's progress labour, although knowing dilation poor predictor when she will give birth. Patterns speed labour can vary substantially between different women, same woman labours. Very slow labours associated with difficulties for both mother baby. Abnormally (dystocia) sometimes lead neurological problems long-term urinary fecal incontinence mother, especially low-income countries. aim reassure (and staff) that labouring normally, early warning if this not case. In countries, take some time get help, vaginal may enable appropriate transfer community settings hospital care. If are slow, but abnormal, mis-diagnosed as unnecessary interventions such drugs try or caesarean section forceps giving There also concerns introducing infection uterus baby, countries where disposable gloves, reusable gloves disinfectants, readily available. addition, women find process uncomfortable distressing, so important there good evidence its use. We looked studies see effective routine at reducing mothers babies. The authors found two studies, undertaken 1990s high-income their quality was unclear. One study, involving 307 compared rectal labour. Here, fewer reported were very examinations. The other 150 two-hourly four-hourly examinations, no difference outcomes seen. the identified convincing support, reject, use yet common practice throughout world. More research needed out useful measure normal abnormal progress. examination progress, an urgent need identify evaluate alternative ensure best outcome babies.