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Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes
Dwight J Rouse1, Steven J Weiner, Steven L Bloom
1Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
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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