{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:13:04Z","timestamp":1790381584083,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,9,3]],"date-time":"2015-09-03T00:00:00Z","timestamp":1441238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Giorgio Pardi Research Foundation"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The aim of this study was to analyze how the progression of cervical dilatation in active labor can be predicted by digital assessment in low\u2010risk pregnant women, in spontaneous labor at term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This prospective observational study was performed on 328 women with singleton term gestations experiencing midwife\u2010led labor according to local protocols, progressing to full dilatation and spontaneous delivery without any medical intervention. Mixed nonlinear models were adopted to (i) model individual cervical data into centile curves and (ii) calculate the time needed to gain 1\u00a0cm in cervical dilatation (TNG<jats:sub>1cm<\/jats:sub>) modeled as a function of current dilatation. We correlated the first and the last TNG<jats:sub>1cm<\/jats:sub>on parturients with at least four cervical data points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TNG<jats:sub>1cm<\/jats:sub>showed large variations, both before and after 6\u00a0cm. This variability of natural progression of cervical curves described by the 10th and 90th centiles exceeded the differences observed in published curves from cohorts homogeneous for parity, weight and ethnicity. There was no significant correlation between the first and the last TNG<jats:sub>1cm<\/jats:sub>. Neonatal base excess was not significantly different in women with TNG<jats:sub>1cm<\/jats:sub>&lt;10th centile and &gt;90th centile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rate of cervical dilatation, traced by parsimonious nonlinear mixed models, is largely unpredictable in the case of spontaneous naturally progressing labor, even when possible larger individual variability is excluded by prudent clinical rules. Future research in labor and delivery should be focused on the diagnosis of the causes that lie behind apparently erratic cervical changes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12719","type":"journal-article","created":{"date-parts":[[2015,7,31]],"date-time":"2015-07-31T15:43:00Z","timestamp":1438357380000},"page":"1136-1144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Progression of cervical dilatation in normal human labor is unpredictable"],"prefix":"10.1111","volume":"94","author":[{"given":"Enrico","family":"Ferrazzi","sequence":"first","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Milan Italy"},{"name":"Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvano","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Clinical and Community Sciences Medical Statistics and Biometry University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Milan Italy"},{"name":"Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Livio","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Milan Italy"},{"name":"Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Piola","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Milan Italy"},{"name":"Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Brusati","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Milan Italy"},{"name":"Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Paganelli","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Milan Italy"},{"name":"Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ajog.2014.01.026","article-title":"Safe prevention of the primary cesarean delivery","volume":"3","author":"Caughey AB","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181fdef6e"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2011.11.012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(54)90311-7"},{"key":"e_1_2_10_6_1","volume-title":"Intrapartum care: care of healthy women and their babies during childbirth. 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