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Labor Patterns Differ for Vaginal and Caesarean Delivery

Center of uterine activity can move upward or downward

FRIDAY, Jan. 9 (HealthDay News) -- The direction and timing of contractions during labor are different for vaginal and Caesarean deliveries, according to study findings published in the January issue of the American Journal of Obstetrics & Gynecology.

Tammy Y. Euliano, M.D., from the University of Florida College of Medicine in Gainesville, and colleagues determined the center of uterine electrical activity in 12 women undergoing Caesarean delivery using 30-minute segments of the electrohysterogram during active-phase arrest and in 24 matched women delivering vaginally using the same active-phase dilation.

The researchers found that the center of uterine activity moved predominantly upwards towards the fundus in women with normal dilation. In contrast, contractions moved primarily downwards towards the lower uterine segment in women delivering by Caesarean, they note. The area under the receiver-operating characteristic curve was 0.91 to predict a Caesarean or vaginal delivery after taking into account gestational age, body mass index, parity, spontaneous versus induced labor, dilation at the time of study and dilation patterns, the report indicates.

"The results of this study are novel as they support unequivocally the existence of a center of uterine activity," Catalin S. Buhimschi, M.D., from Yale University in New Haven, Conn., writes in an accompanying editorial. The study "makes evident the value of electrohysterography in identifying patients with labor dystocia."

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