title: Activity level during a one-hour labor check evaluation: walking versus bed rest.
abstract: OBJECTIVE
  Determine if bed rest or walking during a 1-hour labor check evaluation affects progression to delivery.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Convenience sample of nulliparous full-term, low-risk women with an initial negative exam for active labor (cervical dilatation < 4 cm; intact membranes) were randomly assigned to bed rest or walking for 1 hour prior to reassessment. Cervical dilatation and comfort level were evaluated before and after 1 hour of bed rest or walking. For patients who delivered within 24 hours, time to delivery was documented. Data were analyzed with Student's t-test and c-test. Positive and negative predictive values were calculated for the 1-hour labor check evaluation as a screen for delivery within 24 hours (negative screen = no change in cervical dilatation after 1 hour; positive screen = ≥1 cm change in cervical dilatation after 1 hour).
  
  
  RESULTS
  Sixty-three participants were studied before and after a 1-hour period of bed rest (n = 32) or walking (n = 31). No differences were found between the groups in changes of cervical dilatation, time to delivery, number of women delivering within 24 hours, or maternal comfort after the 1-hour labor check evaluation. Predictive values of the 1-hour labor check evaluation to determine delivery within 24 hours were 88.2% (positive predictive value) and 54.3% (negative predictive value).
  
  
  CONCLUSIONS
  Cervical dilatation and time to delivery were similar for nulliparous, full-term, low-risk women regardless of activity level during a 1-hour, in-hospital labor check evaluation. The woman's preference can be used to determine activity level during a labor check evaluation. Positive 1-hour labor check evaluations were highly predictive of delivery within 24 hours. A negative 1-hour labor check evaluation, however, was not a good predictor of delivery within 24 hours.
authors.affiliation: Labor and Delivery Unit, Saint Luke's Hospital of Kansas City, Kansas City, MO, USA. cselby@saint-lukes.org
authors.forename: Chris
authors.initials: C
authors.lastname: Selby
authors.forename: Sherry
authors.initials: S
authors.lastname: Valencia
authors.forename: Lindsay
authors.initials: L
authors.lastname: Garcia
authors.forename: Denise
authors.initials: D
authors.lastname: Keep
authors.forename: Jonnie
authors.initials: J
authors.lastname: Overcash
authors.forename: Jasmin
authors.initials: J
authors.lastname: Jackson
mesh_terms: D000328:Adult; D001510:Bed Rest; D036861:Delivery, Obstetric / Q000379:methods* / Q000451:nursing; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First; D008429:Maternal Welfare; D010298:Parity; D018743:Perinatal Care / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016138:Walking; D055815:Young Adult