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dc.contributor.authorShepherd, Ashleyen_UK
dc.contributor.authorCheyne, Helenen_UK
dc.contributor.authorKennedy, Susanen_UK
dc.contributor.authorMc Intosh, Coletteen_UK
dc.contributor.authorStyles, Maggieen_UK
dc.contributor.authorNiven, Catherineen_UK
dc.description.abstractBackground: Vaginal examination (VE) and assessment of the cervix is currently considered to be the gold standard for assessment of labour progress. It is however inherently imprecise with studies indicating an overall accuracy for determining the diameter of the cervix at between 48-56%. Furthermore, VEs can be unpleasant, intrusive and embarrassing for women, and are associated with the risk of introducing infection. In light of increasing concern world wide about the use of routine interventions in labour it may be time to consider alternative, less intrusive means of assessing progress in labour. The presence of a purple line during labour, seen to rise from the anal margin and extend between the buttocks as labour progresses has been reported. The study described in this paper aimed to assess in what percentage of women in labour a purple line was present, clear and measurable and to determine if any relationship existed between the length of the purple line and cervical dilatation and/or station of the fetal head. Methods: This longitudinal study observed 144 women either in spontaneous labour (n=112) or for induction of labour (n=32) from admission through to final VE. Women were examined in the lateral position and midwives recorded the presence or absence of the line throughout labour immediately before each VE. Where present, the length of the line was measured using a disposable tape measure. Within subjects correlation, chi-squared test for independence, and independent samples t-test were used to analyse the data. Results: The purple line was seen at some point in labour for 109 women (76%). There was a medium positive correlation between length of the purple line and cervical dilatation (r=+0.36, n=66, P=0.0001) and station of the fetal head (r=+0.42, n=56, P<0.0001). Conclusions: The purple line does exist and there is a medium positive correlation between its length and both cervical dilatation and station of the fetal head. Where the line is present, it may provide a useful guide for clinicians of labour progress along side other measures. Further research is required to assess whether measurement of the line is acceptable to women in labour and also clinicians.en_UK
dc.publisherBioMed Central Ltden_UK
dc.relationShepherd A, Cheyne H, Kennedy S, Mc Intosh C, Styles M & Niven C (2010) The purple line as a measure of labour progress: a longitudinal study. BMC Pregnancy and Childbirth, 10, Art. No.: 54.
dc.rights© 2010 Shepherd et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_UK
dc.subjectEye Refractive errors Treatmenten_UK
dc.subjectNewborn infants Abnormalitiesen_UK
dc.subjectPremature babies Abnormalitiesen_UK
dc.titleThe purple line as a measure of labour progress: a longitudinal studyen_UK
dc.typeJournal Articleen_UK
dc.citation.jtitleBMC Pregnancy and Childbirthen_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.affiliationHealth Sciences Research - Stirling - LEGACYen_UK
dc.contributor.affiliationNHS Forth Valleyen_UK
dc.contributor.affiliationHS UG Regulated - Stirling - LEGACYen_UK
dc.contributor.affiliationHS UG Regulated - Stirling - LEGACYen_UK
rioxxterms.typeJournal Article/Reviewen_UK
local.rioxx.authorShepherd, Ashley|0000-0002-7687-4586en_UK
local.rioxx.authorCheyne, Helen|0000-0001-5738-8390en_UK
local.rioxx.authorKennedy, Susan|en_UK
local.rioxx.authorMc Intosh, Colette|en_UK
local.rioxx.authorStyles, Maggie|en_UK
local.rioxx.authorNiven, Catherine|en_UK
local.rioxx.projectInternal Project|University of Stirling|
local.rioxx.filenameShepherd et al_BMC PC_2010.pdfen_UK
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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