Vaginal examinations aim to reassure the woman and staff that the woman is labouring normally, and to provide early warning if this is not the case. Patterns and speed of labour can vary substantially between different women, and in the same woman in different labours. We also excluded trials with a primary focus on assessing progress of labour using the partogram of which vaginal examinations is one component as this is covered by another Cochrane review. More research is needed to find out if vaginal examinations are a useful measure of both normal and abnormal labour progress. On the basis of women's preferences, vaginal examination seems to be preferred to rectal examination. However, over-diagnosis of dystocia can lead to iatrogenic morbidity from unnecessary intervention e. We identified no difference in the secondary outcomes of augmentation, caesarean section , spontaneous vaginal birth, operative vaginal birth, perinatal mortality and admission to neonatal intensive care. Comparing two-hourly vaginal examinations with four-hourly vaginal examinations in labour, we found no difference in length of labour mean difference in minutes MD
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