Prediction of duration of active labor in nulliparous women at term.

We have assessed the independent predictors of duration of active labor in nulliparous women at term. Using a cohort of 1067 nulliparae in spontaneous labor at > 37.0 weeks with singleton fetuses in vertex presentation, multivariate analysis was used to identify independent predictors of duration of active labor. Duration of active labor was 4.1 +/- 2.4 hours. Stepwise linear regression selected 10 independent predictors of duration of active labor: gestational age at delivery ( P < 0.001), race ( P = 0.014), obstetric risk factors ( P = 0.022), amniotomy ( P < 0.001), fundal height ( P = 0.005), cervical dilation on admission ( P < 0.001), frequency of contractions ( P < 0.001), station of presenting part ( P < 0.001), oxytocin ( P < 0.001), and epidural use ( P < 0.001). A prediction formula incorporating the 10 predictors accounted for 51% of the total variance of the observed duration of active labor. Ten variables are independent predictors of duration of active labor; when incorporated in a prediction formula they account for > 50% of the variability of duration of labor in nulliparous women.

Double incontinence in urogynecologic practice: a new insight.

OBJECTIVES: This study was undertaken to evaluate the prevalence of anal incontinence in an urogynecologic setting and to investigate the relationship between lower urinary tract dysfunction and anal incontinence. STUDY DESIGN: The study included 504 women referred to our urogynecologic outpatient clinic who were prospectively investigated and asked specific questions on anal incontinence. Clinical and instrumental data were compared between women with urinary incontinence and with double incontinence, with further analysis for subgroups in the anal incontinent group of women (passive/urge). For continuous variables, the Wilcoxon rank sum test was used, and the Fisher exact test was applied to dicotomic variables. Logistic regression was used for categorical data. A level of P<.005 was considered significant. RESULTS: Of the investigated women, 20.2% were also anally incontinent. Women with double incontinence showed higher scores for urinary urgency (P=.010), which reached the established level of significance only in the subgroup with urge anal incontinence (P=.003). In this group, a higher prevalence of detrusor overactivity was observed. CONCLUSION: Anal incontinence is highly prevalent among women with lower urinary tract disorders. The existence of subgroups of patients having different kinds of anal and urinary disorders should be taken into consideration both for research purposes and for new treatment perspectives.