The relationship between Cormic Index and labor progress

Document Type : Original Article

Authors

1 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. student, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

4 Professor, Department of Biostatistics, Neonatal Research Center, School of health, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Associate professor, Department of Obstetrics & Gynecology, Women,s Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Labor progress assessment is one of the key factors of maternal care during labor. Anthropometry is one of the branches of anthropology which includes the measurement of different parts of human body. Many studies have assessed the relationship between anthropometric indices and labor disorders. One of these common indices is Cormic Index which defines as: "(sitting height/standing height) × 100". This study was performed with aim to determine the relationship between Cormic Index and labor progress.
Methods: This correlation study was performed on 151 nulliparous G2 pregnant women referred to Mashhad Omolbanin hospital during 2014-2015. Standing and sitting heights were measured at cervical dilatation of 3-5 cm. Then, vaginal examinations were done hourly to assess cervical dilatation and fetal head descent up to delivery time. Data were analyzed using SPSS software (version 16), and Independent t-test, Spearman correlation coefficient test, repeated measures analysis, and Chi-square test. PResults: The mean Cormic Index was 51.84±2.62 and mean duration of the active phase of labor first stage was 268.83±192.62 min and mean duration of labor second stage was 35.54±34.88 min. There was no significant difference between Cormic Index in two groups of normal and abnormal labor progress in the active phase of labor first stage (P = 0.65). However, there was a positive correlation between Cormic Index and the duration of labor second stage (rs=0.19, P= 0.02). Moreover, the relationship between Cormic Index and fetal head status untill sixth hour was statistically significant (P<0.05).
Conclusion: There is no relationship between Cormic Index and labor progress in the active phase of labor first stage. However, there is a relationship between Cormic Index and duration of labor second stage and fetal head descent, so that whatever the trunk is taller (the higher Cormic Index), labor second stage will be longer. Therefore, the labor progress in the latent phase or at the beginning of active phase of labor can be assessed based on Cormic Index.

Keywords


  1. Cunningham FG, Leveno KJ, Bloom SL, Hauth J, Gilstrap L, Wenstrom K. Williams obstetrics. 24th ed. New York: McGraw-Hill Medical Publishing Division; 2014.
  2. Gabbe SG, Niebyl JR, Simpson JL. Obstetrics: normal and problem pregnancies. 5th ed. New York: Elsevier Health Sciences; 2007.
  3. Taghinezhad H, Sohrabi Z, Mahaki B. Comparison of pethidine hydrochloride and diclofenac sodium (Dykln) on pain after cesarean. J Ilam Med Sci 2006; 14(4):7-12. (Persian).
  4. Varney H, Kriebs JM, Gegor CL. Varney's midwifery. 4th ed. Massachusetts: Jones & Bartlett Learning; 2008.
  5. Higgins M, Farine D. Assessment of labor progress. Expert Rev Obstet Gynecol 2013; 8(1):83-95.
  6. Shepherd A, Cheyne H. The frequency and reasons for vaginal examinations in labour. Women Birth 2013; 26(1):49-54.
  7. Simkin P, Ancheta R. The labor progress handbook: early interventions to prevent and treat dystocia. 3rd ed. New Jersey: John Wiley and Sons; 2011.
  8. Kordi M, Rohani Mashhadi S, Fadaee A, Esmaili H. Effects of SP6 acupressure on reducing the labor pain during first stage of delivery. Iran J Obstet Gynecol Infertility 2010; 12(4):7-13. (Persian).
  9. Faramarzi M, Esmaeelzade S. Identification and prediction of overdiagnosis of dystocia. J Gorgan Univ Med Sci 2005; 7(1):66-71. (Persian).
  10. Zhu Bp, Grigorescu V, Le T, Lin M, Copeland G, Barone M, et al. Labor dystocia and its association with interpregnancy interval. Am J Obstet Gynecol 2006; 195(1):121-8.
  11. Ebrahimzadeh Zagami S, Golmakani N, Saadatjoo SA, Ghomian N, Baghbani B. The shape of uterine contractions and labor progress in the spontaneous active labor. Iran J Med Sci 2015; 40(2):98-103.
  12. Creedon C, Akkerman D, Atwood L, Bates L, Harper C, Levin A, et al. Management of labor. Tanzania: Concern; 2013.
  13. Kordi M, Irani M, Esmaeily H, Tara F. The relationship between length of purple line and cervical dilation in active phase of labor. Iran J Obstet Gynecol Infertility 2013; 15(37):6-13. (Persian).
  14. Downe S, Gyte GM, Dahlen HG, Singata M. Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term. Cochrane Database Syst Rev 2013; 7:CD010088.
  15. Kwawukume EY, Ghosh TS, Wilson JB. Maternal height as a predictor of vaginal delivery. Int J Gynecol Obstet 1993; 41(1):27-30.
  16. Mortezaee K, Sabbaghziarani F, Hassanzadeh G, Alaghbandha N, Dehbashipour A. Anthropometric features of body index in natives of Qazvin, Iran. Anatom Sci J 2013; 10(3):166-71.
  17. Kominiarek MA, Zhang J, VanVeldhuisen P, Troendle J, Beaver J, Hibbard JU. Contemporary labor patterns: the impact of maternal body mass index. Am J Obstet Gynecol 2011; 205(3):244.e1-8.
  18. Cedergren MI. Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index. Eur J Obstet Gynecol Reprod Biol 2009; 145(2):163-6.
  19. Vahratian A, Zhang J, Troendle JF, Savitz DA, Siega-Riz AN. Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol 2004; 104(5 Pt 1):943-51.
  20. Zhang J, Bricker L, Wray S, Quenby S. Poor uterine contractility in obese women. BJOG 2007; 114(3):343-8.
  21. Liselele HB, Boulvain M, Tshibangu KC, Meuris S. Maternal height and external pelvimetry to predict cephalopelvic disproportion in nulliparous African women: a cohort study. BJOG 2000; 107(8):947-52.
  22. Rozenholc AT, Ako SN, Leke RJ, Boulvaina M. The diagnostic accuracy of external pelvimetry and maternal height to predict dystocia in nulliparous women: a study in Cameroon. BJOG 2007; 114(5):630-5.
  23. McGuinness BJ, Trivedi AN. Maternal height as a risk factor for caesarean section due to failure to progress in labour. Aust N Z J Obstet Gynecol 1999; 39(2):152-4.
  24. Ridgeway B, Arias BE, Barber MD. The relationship between anthropometric measurements and the bony pelvis in African American and European American women. Int Urogynecol J 2011; 22(8):1019-24.
  25. Van Bogaert LJ. The relation between height, foot length, pelvic adequacy and mode of delivery. Eur J Obstet Gynecol Reprod Biol 1999; 82(2):195-9.
  26. Awonuga AO, Merhi Z, Awonuga MT, Samuels TA, Waller J, Pring D. Anthropometric measurements in the diagnosis of pelvic size: an analysis of maternal height and shoe size and computed tomography pelvimetric data. Arch Gynecol Obstet 2007; 276(5):523-8.
  27. Liselele HB, Tshibangu CK, Meuris S. Association between external pelvimetry and vertex delivery complications in african women. Acta Obstet Gynecol Scand 2000; 79(8):673-8.
  28. Kara F, Yesildaglar N, Uygur D. Maternal height as a risk factor for caesarean section. Arch Gynecol Obstet 2005; 271(4):336-7.
  29. Burton RF, Nevill AM, Stewart AD, Daniell N, Olds T. Statistical approaches to relationships between sitting height and leg length in adults. Ann Hum Biol 2013; 40(1):64-9.
  30. Ukwuma MC. A study of the cormic index in a southeastern Nigerian population. Int J Biol Anthropol 2009; 4(1):1-6.
  31. Sebhatu B. Determining the sensitivity of sitting height in predicting cephalo pelvic disproportion in Eritrea. Trop Doct 2005; 35(4):204-6.
  32. Stewart KS, Philpott RH. Fetal response to cephalopelvic disproportion. Br J Obstet Gynaecol 1980; 87(8):641-9).