Intrauterine pressure during the second stage of labor in obese women.

摘要: Objective The perception that obese women have longer labors and a higher frequency of operative delivery because they are "poor pushers" persists despite the absence objective study. We tested hypothesis generate inadequate intrauterine pressure during second stage labor. Methods Intrauterine was prospectively measured in 71 Obesity defined as body mass index (BMI) greater than 29 (n = 17). A BMI below 25 normal 40). Women with between 26 14) were considered overweight. All labored epidural analgesia alert responsive throughout After recording baseline contractility, standardized Valsalva maneuver performed contractions. area under curve (integral) used an estimate uterine contractility. Results delivered vaginally. There no significant differences contractility among obese, overweight, either before (obese 1,787 mm Hg/s; 95% confidence interval [CI] 1,164, 2,742 versus 1,569 CI 718, 2,371 overweight 1,770 1,305, 2,835; P =.223) or 2,831 1,771, 4,599 2,637 1,240, 4,390 2,813 1,209, 4,982; =.742). associated oxytocin augmentation (P =.037). Univariate analysis revealed relationship labor duration (r 0.299, =.018). Obese active phase (one-way variance, =.02), but second-stage similar groups variance =.44). did not increase incidence perineal lacerations =.82) (relative risk nonobese 0.212; 0.04, 1.05). Conclusion produce pressures equivalent to BMI, although may require more often. Level evidence II-2