An a priori hypothesis of the study was that labour dystocia, defined as cervical dilation slower than 1 cm per hour or a delayed progress beyond Enzastaurin MM two hours, is associated with a higher level of negative childbirth experience among recently delivered, primiparous women. The study also aimed to explore the association of the outcome variable with other possible risk factors, including an elevated AFL level. Methods A prospective observational study called `the dysfunctional labour study�� was performed at Soder Hospital Stockholm, Sweden between April 2010 and January 2012. Healthy, Swedish speaking, nulliparous women, with a singleton pregnancy and a gestational age between 37 42 weeks, were asked to participate.

A number of criteria for inclusion were formulated labour should have started spontaneously, the foetus should be in a cephalic presentation, the cervical dilation should be at least 3 cm and regular, painful contractions should be present. A group of 25 140 midwives at the Soder Hospital Inhibitors,Modulators,Libraries clinic volunteered to assist in data collection and informed the labouring women about the ongoing study. In all, 561 healthy primiparous women in labour, presenting consecutively, were invited to participate in Inhibitors,Modulators,Libraries this study as they fulfilled the inclusion criteria. Of these, seven declined to participate and 107 were excluded later due to incomplete ID or an incomplete questionnaire. One woman was excluded due to intrapartum death of the infant. The remaining 446 women constituted our material for the survey. A written informed consent for participation in the study was obtained from all participants.

Inhibitors,Modulators,Libraries The study was approved by the Karolinska Institute Human Research Ethics Committee. All women included were asked to complete the Wijma Delivery Experience Questionnaire the day after delivery. The W DEQ B measures the woman��s Inhibitors,Modulators,Libraries experience of childbirth after delivery. The questionnaire Inhibitors,Modulators,Libraries includes 33 items, each scoring from 0 5. The sum score ranges from 0 165. the higher the score, the worse the womans experience. The questionnaire has shown good psychometric properties. The cut off between good moderate and negative experience of childbirth was set at a sum score of 66, which was the 75th percentile in the original study of childbirth experience. The two groups were compared with regard to levels of AFL, and labour variables in several parameters.

In addition to the W DEQ, seven questions were added relating to nourishment, sleep, the presence of the midwife during labour and thoughts about a subsequent pregnancy and delivery. In calculating the outcome, the same scale was used as in the original W DEQ B questionnaire, with a scoring range selleck inhibitor from 0 5. The questionnaire was collected after delivery but before the woman was discharged from hospital. In order to detect labour dystocia, the WHO modified partogram was used with an alert line and a two hours displaced action line, as recommended in Sweden at the time of the study.