Obstetric Outcomes among Low Risk Parturients when Active Phase of Labor is defined at a Cervical Dilatation of 6 versus 4 Centimeters

Hasan, Asmaa H.; Yusuf, Nada Habib

doi:10.33762/mjbu.2026.165782.1325

	Obstetric Outcomes among Low Risk Parturients when Active Phase of Labor is defined at a Cervical Dilatation of 6 versus 4 Centimeters
The Medical Journal of Basrah University
Article 6, Volume 44, Issue 1, July 2026, Pages 43-52 PDF (189.06 K)
Document Type: Research Paper
DOI: 10.33762/mjbu.2026.165782.1325
Authors
Asmaa H. Hasan^* ¹; Nada Habib Yusuf²
¹Basrah University
²College of Medicine –University of Basra
Abstract
Background: Labor is the physiological process by which the fetus and placenta are expelled from the uterus through the vaginal canal. Management of normal labor involves monitoring maternal vitals, cervical progress, and labs, while minimizing interventions. Active labor, once defined at 4 cm dilation, is now considered to begin at 6 cm, impacting obstetric management and outcomes. Objectives: This study aims to compare maternal and neonatal outcomes, alongside labor interventions, when defining active labor onset at 4 cm versus 6 cm cervical dilation. Methods: A prospective case-control study was conducted at Al-Mawanee Teaching Hospital, Basrah, for the period from 1st of November 2024 to 30th of July 2025. Eligible term, singleton, cephalic pregnancies were included. Data collection involved questionnaires, examinations, and monitoring of labor management, maternal complications, and neonatal outcomes. Results: This study compared outcomes among 200 women admitted in labor at 4 cm versus 6 cm cervical dilation. Significant differences included maternal age (older in 6 cm group, p=0.04) and parity (more nulliparas at 4 cm, p=0.003). Cervical consistency was softer in the 6 cm group (p=0.028), and fetal head station was more advanced (p=0.05). Cesarean indications differed (p=0.032): fetal distress predominated at 6 cm, poor progress at 4 cm. maternal complications and neonatal outcomes showed no significant differences. Conclusions: Admission at 4 cm was linked to longer labor, more oxytocin use, and cesareans for poor progress, while 6 cm showed better readiness. Overall cesarean rates, maternal complications, and neonatal outcomes were similar.
Keywords
Obstetric Outcomes; Low Risk Parturients; Active Phase; Labor

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