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Factors influencing the prolonged second stage and the effects on perinatal and maternal outcomes
1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Objective:
To examine the factors influencing the prolonged second stage and the maternal-perinatal outcomes after a prolonged second stage of labor.
Methods:
Between January 1993 and June 1993, 165 women who delivered with a prolonged second stage of labor were enrolled in this study. The control group was 1750 term pregnancies that delivered under 2 hours in the second stage. Maternal and neonatal outcomes included one and 5 minute Apgar scores, umbilical blood gas determination, thick meconium stain, fetal trauma, and length of hospital stay.
Results:
Factors such as nulliparity (p < 0.005), maternal weight gained during pregnancy (p < 0.01), active phase length (p < 0.05), persistent occiput posterior position (p < 0.05), station at complete cervical dilation (p < 0.05) and a need of instrumental vaginal delivery (p < 0.05) were significantly associated with a prolonged second stage of labor. Maternal and neonatal outcomes were not different significantly between the study and control group.
Conclusion:
The maternal and perinatal well-beings from the normal second stage group did not appear to be more favorable than the prolonged second stage. Under monitored condition, if the fetal heart rate is considered normal, then the natural labor course could be continued.