AI Article Synopsis
- The study examined how the length of the second stage of labor affects both maternal and newborn health outcomes.
- Among 4,126 first-time mothers analyzed, longer durations in the second stage correlated with a significant decrease in successful vaginal deliveries and an increase in maternal complications like infections and severe lacerations.
- The findings suggest that while longer second-stage labor has some risks, it does not necessarily warrant premature intervention strictly based on duration.
Article Abstract
Objective: The purpose of this study was to assess maternal and perinatal outcomes as a function of second-stage labor duration.
Study Design: We assessed outcomes in nulliparous laboring women who were enrolled in a trial of fetal pulse oximetry.
Results: Of 5341 participants, 4126 women reached the second stage of labor. As the duration of the second stage increased, spontaneous vaginal delivery rates declined, from 85% when the duration was <1 hour to 9% when it was > or =5 hours. Adverse maternal outcomes that were associated significantly with the duration of the second stage of labor included chorioamnionitis (overall rate, 3.9%), third- or fourth-degree perineal laceration (overall rate, 8.7%), and uterine atony (overall rate, 3.9%). Odds ratios for each additional hour of the second stage of labor ranged from 1.3-1.8. Among individual adverse neonatal outcomes, only admission to a neonatal intensive care unit was associated significantly with second stage duration (odds ratio, 1.4).
Conclusion: The second stage of labor does not need to be terminated for duration alone.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768280 | PMC |
| http://dx.doi.org/10.1016/j.ajog.2009.08.003 | DOI Listing |
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