Friedman's Curve...do you use it?

hi all!

i am brand new to the boards. i have been practicing in ob/gyn nursing in a small community hospital for almost 4 years. recently, we re-vamped our charting forms. yes, we are still doing hand-written charting. i was in charge of completely transforming our labor progress form from the hollister form to one tailored for us. one thing i left off the new form was the friedman's curve. it was seldom used, and if it was, it was graphed incorrectly. no one misses it except our nurses that have been there for 25+ years.

so, i was given the task of finding out what other hospitals are doing with the friedman's curve. are you using it? do you think it is necessary? any recent research? any opinions at all would be welcome.

thanks so much for your help!!

we have a graph across the top of our labor flow sheet which is the friedman curve, but no one depends on it. we chart our exams there (which are far and few between) but no one really depends on it, unless the laboring woman has been the same dilitation for hours on end.

if you wuold like me to send you a copy, send me your name and address and i'll pop one in the mail. my regular e-mail is **edited for privacy** :rotfl:

The doctors do when t hings are "falling off", otherwise no one does. I think it's perhaps at best a fair guide, but not something we should adhere strictly to, esp in EARLY labor. It does some people a real disservice.

I haven't seen the curve on the charts of the three hospitals I have been at. We don't use it, although the MDs will sometimes refer to it when they want to section someone who has been stalled for a while. I have been reading in AWHONN publications that it is being revised based on more current stats.

We don't use it...and it's no where to be found in our charts....

Since I didn't know what Friedman's Curve was, I looked it up.

I thought you may find this interesting:

The Friedman Curve: An Obsolete Approach to Labor Assessment

http://www.medscape.com/viewarticle/450311

Full original source: Zhang J et al. Reassessing the labor curve in nulliparous women. Am J Obstet Gynecol 2002 Oct; 187:824-8.

also:

Use of abnormalities in the Friedman curve as a predictor of operative delivery in macrosomic babies ("Abnormalities in the Friedman curve were not useful as a predictor for operative delivery in pregnancies complicated by fetal macrosomia.").

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9766416&dopt=Abstract

Thanks for your replies. I'll have something to take back to the couple of nurses on our unit that just don't quite want to see it go. :)