title: Reducing cesarean delivery rates: an active management labor program in a setting with limited resources.
abstract: OBJECTIVE
  To determine the effect of an active management of a labor program on the rate of cesarean section and labor outcomes in low-risk nulliparous pregnancies in a setting with limited resources.
  
  
  METHODS
  Nine hundred and seventy-five low risk nulliparous pregnant women were randomized to receive either active management of a labor program (n = 325) or conventional management (n = 650). The rate of cesarean section and labor outcomes were compared between the two groups using Chi-square and t-tests.
  
  
  RESULTS
  The subjects in the active management program had significantly shortened first stage of labor and total duration of labor compared with the conventional group (538.0 +/- 242.9 min vs 589.4 +/- 263.8 min, p < 0.05, 539.3 +/- 261.4 min vs 610.3 +/- 264.4 min, p < 0.001, respectively). There was no statistical difference found in the rate of cesarean section and other labor outcomes.
  
  
  CONCLUSIONS
  The active management program shortened the first stage and duration of labor in low-risk nulliparous pregnant women.
authors.affiliation: Department of Obstetrics and Gynecology, Thammasat University, Klong-Luang, Pathumthani 12120, Thailand. Charintipsom@hotmail.com
authors.forename: Charintip
authors.initials: C
authors.lastname: Somprasit
authors.forename: Chamnan
authors.initials: C
authors.lastname: Tanprasertkul
authors.forename: Atiwut
authors.initials: A
authors.lastname: Kamudhamas
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000379:methods*; D003906:Developing Countries; D005260:Female; D006295:Health Resources; D006801:Humans; D007743:Labor, Obstetric; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D013785:Thailand