Document Detail


Maternal and neonatal outcomes in patients with a prolonged second stage of labor.
MedLine Citation:
PMID:  12850607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine risk factors for a prolonged second stage of labor and evaluate the maternal and neonatal outcomes of such pregnancies. METHODS: We reviewed all 7818 patients who delivered at the University of Illinois at Chicago from 1996 to 1999. Excluding nonvertex and multiple gestations, 6791 reached the second stage. Group 1 (n = 6259) consisted of patients with a second stage of 120 minutes or less; group 2, greater than 120 minutes (n = 532 [7.8%]); group 2A, 121-240 minutes (n = 384 [5.7%]); and group 2B, greater than 240 minutes (n = 148 [2.2%]). We compared pregnancy outcomes for these groups with respect to maternal and neonatal morbidity factors using chi(2), Student t, and Wilcoxon rank-sum tests (significance, P <.05). RESULTS: Vaginal delivery rates were 98.7% (group 1), 84.0% (group 2), 90.2% (group 2A), and 65.5% (group 2B). Group 2 had higher rates of perineal trauma, episiotomy usage, chorioamnionitis, postpartum hemorrhage, and operative vaginal delivery than group 1 (P <.001, all comparisons). Group 2B had higher rates of episiotomy usage, operative vaginal deliveries, and perineal trauma than group 2A (P <.001, all comparisons). The neonatal morbidity rates were similar for the three groups. Diabetes, preeclampsia (P <.023), macrosomia, nulliparity, chorioamnionitis, oxytocin usage, and labor induction were each independently associated with an increased risk of a prolonged second stage (all but preeclampsia, P <.001). CONCLUSION: A prolonged second stage is associated with a high rate of vaginal delivery, but a high rate of maternal, though not neonatal, morbidity was observed. Certain antenatal and intrapartum conditions are associated with a prolonged second stage of labor.
Authors:
Thomas D Myles; Joaquin Santolaya
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-08-22     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  52-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Saint Louis University, St. Mary's Health Center, St. Louis, Missouri 63117, USA. mylesth@slucare1.sluh.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Delivery, Obstetric / adverse effects*,  methods
Female
Gestational Age
Humans
Infant Mortality
Infant, Newborn
Labor Stage, Second*
Maternal Mortality
Morbidity / trends*
Multivariate Analysis
Obstetric Labor Complications / diagnosis*,  mortality
Odds Ratio
Parity
Pregnancy
Pregnancy Outcome*
Probability
Retrospective Studies
Risk Factors
Statistics, Nonparametric
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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