title: The diagnostic accuracy of purple line in prediction of labor progress in omolbanin hospital, iran.
abstract: BACKGROUND
  Currently, vaginal examination is the gold standard for assessment of labor progress. The World Health Organization emphasizes that the number of vaginal examinations should be limited where it is necessary.
  
  
  OBJECTIVE
  Therefore, this study aimed to determine the diagnostic accuracy of purple line in the prediction of labor progress.
  
  
  METHODS
  In this cross-sectional study, 350 women with a single pregnancy in vertex presentation and gestational age of 38-42 weeks without any medical disorder, admitted to government hospitals of Mashhad, were selected using convenience sampling. Vaginal examination and observation of the line each hour in the active phase of labor were measured. Abnormal progress of labor was defined as cervical dilatation less than 1 centimeter/hour in the active phase for two consecutive hours and fetal head descend less than 1cm/h or duration of more than two hours for nulliparous and one hour for multiparous In the second stage of labor. Data was analyzed by SPSS version 16 using chi -square test.
  
  
  RESULTS
  The purple line appeared in 75.3% of women during the active phase of labor. Appearance of the purple line in the prediction of labor progress had 90.2% sensitivity, 45.3% specificity, 88.1% positive predictive value, 51.0% negative predictive value in the first stage of labor and had 87.6% sensitivity, 52.4% specificity, 96.5% positive predictive value, 22.0% negative predictive value in the second stage of labor and has 68.57% sensitivity, 42.66% specificity, 85.32% positive predictive value, and 43.85% negative predictive value for the total labor.
  
  
  CONCLUSIONS
  According to the appearance of the purple line in most of the cases and its high sensitivity and specificity, we can use it as a non-invasive complementary method for clinical assessment of labor progress.
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Kordi
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Morvarid
authors.initials: M
authors.lastname: Irani
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Tara
authors.affiliation: Departement of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Habibollah
authors.initials: H
authors.lastname: Esmaily
keywords: Cervical Dilatation; First Stage Labor; Second Stage Labor; Sensitivity and Specificity; Vaginal examinations