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Related Experiment Videos

Perinatal outcome in relation to second-stage duration

S M Menticoglou1, F Manning, C Harman

  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, Canada.

American Journal of Obstetrics and Gynecology
|September 1, 1995
PubMed
Summary

Prolonging the second stage of labor in nulliparous women does not worsen perinatal outcomes. Arbitrary time limits for operative intervention are not supported by this study on labor duration and fetal well-being.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Fetal Monitoring

Background:

  • The second stage of labor is traditionally viewed as a period of significant asphyxial risk for the fetus.
  • This perception has historically justified arbitrary time constraints and increased rates of operative vaginal delivery.
  • Evidence is needed to evaluate the actual impact of second-stage duration on perinatal outcomes.

Purpose of the Study:

  • To investigate the relationship between the duration of the second stage of labor and perinatal outcomes in nulliparous women.
  • To determine if prolonged second stage of labor is associated with adverse fetal or neonatal events.
  • To inform clinical practice regarding time limits in the second stage of labor.

Main Methods:

  • Retrospective review of 6041 nulliparous women at a university teaching hospital over a 5-year period.

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  • Inclusion criteria: live singleton cephalic fetus, birth weight ≥ 2500 gm, reaching the second stage of labor.
  • Analysis correlated second-stage duration with perinatal morbidity and mortality data.

    • Main Results:

    • The second stage of labor exceeded 3 hours in 11% and 5 hours in 2.7% of the studied nulliparous women.
    • No perinatal deaths were recorded that were unrelated to congenital anomalies.
    • No significant association was found between the length of the second stage and low 5-minute Apgar scores, neonatal seizures, or NICU admissions.

    Conclusions:

    • Operative intervention in the second stage of labor should not be based solely on the elapsed time.
    • Clinical decisions regarding intervention should consider individual circumstances rather than arbitrary time limits.
    • The findings challenge the necessity of rigid time-based protocols for managing the second stage of labor.