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The effectiveness of utilizing the Zhang's criteria compared to Friedman's criteria in increasing the rate of successful vaginal delivery among primigravid parturient in a tertiary hospital
Khristine Rosemarie R. Bunda, MD and Alberto R. Mercado, MD, FPOGS
Department of Obstetrics and Gynecology, General Emilio Aguinaldo Memorial Hospital
Material and Methods: This is a prospective cohort study conducted in a tertiary hospital. The population consisting of primigravid parturient of any age admitted at term pregnancy with a gestational age between 37 and 42 weeks. Included were singleton pregnancy, with no co-morbidities, vertex position on admission, with intact amniotic membranes, and in active phase of labor (either 4cm or 6cm cervical dilatation), who consulted at the emergency room of the institution. Multigravid patients, those with multiple pregnancy and ruptured membranes were excluded from the study. Two groups of cohorts were recruited based on the internal examination of the principal investigator upon admission. Cohort A is composed of pregnant women admitted at 6cm cervical dilatation fulfilling the Zhang's criteria whereas Cohort B is composed of pregnant women admitted at 4cm cervical dilatation fulfilling the Friedman's criteria. Socio-demographic characteristics were recorded. Their course of labor was monitored; contractions were augmented accordingly if needed. The mode of delivery was noted such as spontaneous vaginal delivery or cesarean section. The neonatal outcome was recorded as to apgar scores obtained for both groups.
Results: A greater proportion of parturients were young, single and with normal body mass index. A higher proportion of those under Friedman's group was augmented with oxytocin (100% vs. 53.4%). A greater proportion of those in Zhang's group had successful vaginal delivery (98.2% vs. 81.8%) (p=0.011, OR=18.167, 95% CI: 1.943, 169.867). Parturients under Zhang's group had achieved less hours of active labor.
Conclusion: The rate of successful vaginal delivery is significantly different between the two groups. A greater proportion of pregnant women under Zhang's group achieved successful vaginal delivery as compared to Friedman's group.