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Does Delayed Pushing in the Second Stage of Labor Impact Perinatal Outcomes?
MedLine Citation:
PMID:  22773293     Owner:  NLM     Status:  Publisher    
Objective To estimate maternal, neonatal, and labor outcomes associated with delayed pushing.Study Design A retrospective cohort study of all consecutive women admitted to a single institution in labor at term who reached the second stage of labor. Pregnancies with multiple fetuses or major anomalies were excluded. Delayed pushing was defined as initiation of pushing ≥60 minutes after complete dilatation. Primary outcome was mode of delivery. Multivariable logistic regression was used to control for confounding.Results Of the 5290 women who met inclusion criteria, 471 (8.9%) employed delayed pushing, and 4819 (91.1%) pushed immediately. Delayed pushing was associated with increased rates of cesarean, operative vaginal delivery, maternal fever, and lower arterial cord pH. Duration of the second stage and length of time spent pushing were significantly longer with delayed pushing.Conclusion Delayed pushing is associated with lower rates of spontaneous vaginal delivery and increased adverse maternal and neonatal outcomes.
Heather A Frey; Methodius G Tuuli; Sarah Cortez; Anthony O Odibo; Kimberly A Roehl; Anthony L Shanks; George A Macones; Alison G Cahill
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-6
Journal Detail:
Title:  American journal of perinatology     Volume:  -     ISSN:  1098-8785     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
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