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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Hrsg. v. Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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Band 46, Heft 1


Impact factors on cervical dilation rates in the first stage of labor

Jana Juhasova
  • Department of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
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/ Martina Kreft
  • Department of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
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/ Roland Zimmermann
  • Head of Department of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
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/ Nina Kimmich
  • Korrespondenzautor
  • Division of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
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Online erschienen: 08.07.2017 | DOI: https://doi.org/10.1515/jpm-2016-0284



To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors.


In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated.


Cervical dilation rates increase during labor progress with faster rates in multiparous compared with nulliparous women (P<0.001). Dilation rates exceed 1 cm/h at a dilatation of 6–7 cm, but are very individual. Accelerating impact factors are multiparity, a greater amount of cervical dilation and fetal occipitoanterior position, whereas the use of epidural anesthesia, a higher fetal weight and head circumference decelerate dilation (P<0.001).


Cervical dilation is a hyperbolic increasing process, with faster dilation rates in multiparous compared to nulliparous women and a reversal point of labor around 6–7 cm, respectively. Besides, cervical dilation is highly individual and affected by several impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates and on the individual evaluation of every woman.

Keywords: Cervical dilation; dilation rates; first stage of labor; impact factors; labor curve; labor progress; partogram


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Corresponding author: Nina Kimmich, MD, Division of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland, Tel.: 0041-44-255 1111

Erhalten: 25.08.2016

Angenommen: 22.12.2016

Online erschienen: 08.07.2017

Erschienen im Druck: 26.01.2018

Author’s statement

Conflict of interest: Authors state no conflict of interest.

Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

Contribution to authorship: JJ: Data management, statistical analysis, writing of the manuscript. MK: Study design and revision of the manuscript. RZ: Study design and revision of the manuscript. NK: Study design, data management, statistical analysis and writing of the manuscript.

Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

Funding: No funding was obtained for this study.

Quellenangabe: Journal of Perinatal Medicine, Band 46, Heft 1, Seiten 59–66, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0284.

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