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 ≥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.
Original language | English (US) |
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Pages (from-to) | 357.e1-357.e7 |
Journal | American journal of obstetrics and gynecology |
Volume | 201 |
Issue number | 4 |
DOIs | |
State | Published - Oct 2009 |
Keywords
- duration
- nulliparous women
- second stage of labor
ASJC Scopus subject areas
- Obstetrics and Gynecology