Background: Data regarding maternal and fetal morbidities are limited to surgical morbidity per each additional hour in the second stage of labor.
Objective: This study aimed to quantify perinatal morbidities associated with cesarean delivery by duration of the second stage of labor.
Study Design: Our work is a retrospective cohort study of cesarean deliveries during the second stage of labor using the Consortium on Safe Labor database. All term, singleton pregnancies in cephalic presentation were included. Women with stillbirth or contraindications to vaginal delivery were excluded. Groups were divided by duration of the second stage of labor: ≤3 hours, 3-4 hours, 4-5 hours, 5-6 hours, and >6 hours. The primary outcome was a composite of maternal morbidities. The secondary outcomes were a composite of neonatal morbidities and individual maternal and neonatal morbidities. Baseline demographic and clinical characteristics were compared among groups. Univariate and multivariate analyses were performed.
Results: We included 6273 women in total. In addition, 3652 women (58.2%) went through the second stage for ≤3 hours, 854 (13.6%) for 3 to 4 hours, 618 (9.9%) for 4 to 5 hours, 397 (6.3%) for 5 to 6 hours, and 752 (12.0%) for >6 hours. Neither the maternal nor neonatal morbidity composite outcomes were statistically different among the groups. Extended maternal length of stay (>5 days), increased birthweight, and lower rates of general anesthesia were associated with an increased duration of the second stage of labor. Chorioamnionitis, wound complications, postpartum hemorrhage, and thrombosis did not increase over time.
Conclusion: Women should be counseled regarding the duration of the second stage of labor, which should include a discussion of the risks associated with a cesarean delivery with a prolonged second stage of labor. However, these risks may not be as high as anticipated.
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http://dx.doi.org/10.1016/j.ajogmf.2020.100276 | DOI Listing |
Gerontologist
January 2025
Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
Background And Objectives: The Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program provides rental subsidies, case management, and supportive services to Veterans who are currently or formerly homeless, 77% of whom are ages ≥50. Few interventions have been developed to address the needs of older Veterans in HUD-VASH.
Research Design And Methods: We conducted a 2-stage study to inform the development of an intervention to promote aging in place in HUD-VASH.
Med Phys
January 2025
Deparment of Radiation Oncology, Duke University, Durham, North Carolina, USA.
Background: Stereotactic radiosurgery (SRS) is widely used for managing brain metastases (BMs), but an adverse effect, radionecrosis, complicates post-SRS management. Differentiating radionecrosis from tumor recurrence non-invasively remains a major clinical challenge, as conventional imaging techniques often necessitate surgical biopsy for accurate diagnosis. Machine learning and deep learning models have shown potential in distinguishing radionecrosis from tumor recurrence.
View Article and Find Full Text PDFNeurosurgery
January 2025
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Background And Objectives: Jugular paragangliomas (JPG) pose a surgical challenge because of their vascularity and complex location. Stereotactic radiosurgery (SRS) offers a minimally invasive management for patients with JPG. Our aim was to evaluate outcomes of Gamma Knife radiosurgery (GKRS) for the treatment of JPG over the long term.
View Article and Find Full Text PDFJ Clin Ultrasound
January 2025
Inpatient Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Background: To investigate the performance of contrast-enhanced ultrasound(CEUS) parameters of metastatic axillary lymph nodes (ALNs) before and after two courses of neoadjuvant chemotherapy (NAC) in breast cancer patients in predicting the efficacy of NAC.
Methods: A total of 41 postoperative breast cancer patients were selected. All patients underwent NAC, and ALN biopsy was positive before chemotherapy.
Subst Abuse Rehabil
January 2025
Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.
Background: Many studies indicate that high and multiple doses of anabolic-androgenic steroids (AAS) for athletic enhancement can result in serious and irreversible adverse effects. A study that includes laboratory blood testing to evaluate the direct effects of AAS agents among users has not been previously undertaken. The purpose of this study was to investigate the adverse effects of the use of AAS by athletes and to determine whether AAS use leads to changes in certain blood parameters.
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