Comparing Diagnostic Accuracy of Purple line with Transvers Diagonal of Michaelis Sacral to Predict labor Progress

Document Type : Original Research Article

Authors

1 Lecturer, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 MSc in Midwifery, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 Associate professor, Department of Obstetrics & Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Associate professor, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background and Aim: One of the key aspects of maternal care is observing the progress of labor. Careful assessment of labor progress could provide mothers to be referred on time and could decrease the maternal and neonatal morbidity. This study aimed to compare diagnostic accuracy of purple line with transvers diagonal of Michaelis sacral rhomboid to predict labor progress in nulliparous and multiparous women.
Methods: In this double-blind diagnostic accuracy study, 350 nulliparous and multiparous womenwith a single pregnancy in vertex presentation and gestational age of 38-42 week, who admitted in Om-ol-Banin Hospital, Mashhad, Iran, from April to August 2012, were selected using convenience sampling. At first, the transvers diagonal of the Michaelis sacral rhomboid area was measured in cervical dilatation of ≤ 3 centimeters. Then, labor progress and presence or absence of purple lines between the buttocks in the lateral position was hourly controlled in the active phase of labor. Data were analyzed by SPSS Version 16 using Mann-Whitney and Chi-square test.
Results: The mean age of the women was 25/22 (±5) years. Out of the 350 women enrolled, 61/2% were primigravidas and 38/8% were multigravidas. The presence of purple line was accompanied with normal labor progress with 68.57% sensitivity, 42.66% specificity, and 80.57% validity. The transverse diagonal of the Michaelis sacral cut-off point was ≥98.5 millimeter with 86.5% sensitivity, 59.45% specificity and 79.65% validity, which was also accompanied with normal progress of labor.
Conclusion: Considering the diagnostic accuracy of transverse diagonal of the Michaelis sacral and purple line, thetransvers diagonal of Michaelis Sacral is more accurate predictor of labor progress.

Keywords

References

1.Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams Obstetrics. 23rd Edition. New York: The Mc Graw Hill Medical publishing; 2010.
2. Midwives TRCo. Evidence Based Guidelines for Midwifery-Led Care in Labor-Assessing Progress in Labor Practice Points. 2012.
3. Dixon L, Foureur M. The vaginal examination during labor: Is it of benefit or harm? New Zealand College of Midwives Journal 2010; 42:21-26.
4. Kordi M, Alijahan R. The Diagnostic Accuracy of External Pelvimetry to Predict Dystocia in Nulliparous Women. Zahedan Journal of Research in Medical Sciences 2012; 14(6):36-38.
5. Hobbs L. Assessing cervical dilatation without VEs. The Practising Midwife 1998; 1(11):34-35.
6. Shepherd A, Cheyne H, Kennedy S, McIntosh C, Styles M, Niven C. The purple line as a measure of labor progress: a longitudinal study. BioMed Central BMC Pregnancy and Childbirth 2010; 10(1):54.
7. Narchi NZ, Camargo J da CS de, Salim NR, Menezes M de O, Bertolino MM. The use of the “purple line” as an auxiliary clinical method for evaluating the active phase of delivery. Rev Bras Saúde Matern Infant 2011; 11(3):313-322.
8. Hamm B, Forstner R, Beinder E. MRI and CT 0f the female pelvise. 1st ed. londan: Spriger publisher; 2007.
9. Liselele H, Boulvain M, Tshibangu K, Meuris S. Maternal Height and External Pelvimetry to Predict Cephalopelvic Disproportion in Nulliparous African Women: a Cohort Study. British Journal of Obstetrics and Gynaecology 2000; 107(1):947-952.
10. Rozenholc A, Ako S, Leke R, Boulvain M. The Diagnostic Accuracy of External Pelvimetry and Maternal Height to Predict Dystocia in Nulliparous Women: A Study in Cameroon. British Journal of Obstetrics and Gynaecology 2007; 114(1):630-635.
11. Alijahan R, Kordi M, Porjavad M, Ebrahimzadeh
S, Mahmoudian A. The Diagnostic Accuracy of Clinical and External Pelvimetry in Prediction of Dystocia in Nulliparous Women. Journal of Shahid Sadoughi University of Medical Sciences 2011; 19(3):398-407.
12. Alijahan R, Kordi M, Pourjavad P, Ebrahimzadeh S. The Diagnostic Accuracy Of Clinical Pelvimetry In Nulliparous Women. The Iranian Journal of Obstetrics, Gynecology and Infertility 2011; 14(6):29-30.
13. Kordi M, Alijahan R, Pourjavad P, Ebrahimzadeh S, Mahmoudian A. The Diagnostic Accuracy of the Combination of Maternal Height and Transvers Diagonal of Michaelis sacral Rhomboid Area to Predict Dystocia in Nulliparous Women. Journal of Birjand University of Medical Sciences 2011; 17(3):174-182.
14. Bryne D, Edmonds D. Clinical method for evaluating progress in first stage of labor. The Lancet 1990; 335: 122.
15. Bergsjo p, Koss ks. Iinterindividual variation in vaginal examination finding during labor. Acta Obstetrics Gynecol Scandanivia. 1982; 61(6):509-510.
16. Buchmann EJ, Libhaber E. Accuracy of cervical assessment in the active phase of labor. British Journal of Obstetrics and Gynaecology 2007; 114(7):833.
17. Tuffnell DJ, Bryce F, Johnson N, RJ. L. Simulation of cervical changes in labor: reproducibility of expert assessment. The Lancet 1989 4; 2 (8671):1089-90.

Files

Share

How to cite

Statistics