Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes.

Full Abstract

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.

Author information

Author/s: Rouse, Dwight J (DJ); Weiner, Steven J (SJ); Bloom, Steven L (SL); Varner, Michael W (MW); Spong, Catherine Y (CY); Ramin, Susan M (SM); Caritis, Steve N (SN); Peaceman, Alan M (AM); Sorokin, Yoram (Y); Sciscione, Anthony (A); Carpenter, Marshall W (MW); Mercer, Brian M (BM); Thorp, John M (JM); Malone, Fergal D (FD); Harper, Margaret (M); Iams, Jay D (JD); Anderson, Garland D (GD); Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network;

Affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.

Grants: HD21410 (Agency:NICHD NIH HHS) ; HD27860 (Agency:NICHD NIH HHS) ; HD27869 (Agency:NICHD NIH HHS) ; HD27915 (Agency:NICHD NIH HHS) ; HD27917 (Agency:NICHD NIH HHS) ; HD34116 (Agency:NICHD NIH HHS) ; HD34136 (Agency:NICHD NIH HHS) ; HD34208 (Agency:NICHD NIH HHS) ; HD36801 (Agency:NICHD NIH HHS) ; HD40485 (Agency:NICHD NIH HHS) ; HD40500 (Agency:NICHD NIH HHS) ; HD40512 (Agency:NICHD NIH HHS) ; HD40544 (Agency:NICHD NIH HHS) ; HD40545 (Agency:NICHD NIH HHS) ; HD40560 (Agency:NICHD NIH HHS)

Journal and publication information

Publication Type: Comment; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural

Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol), published in United States. (Language: eng)

Reference: 2009-Oct; vol 201 (issue 4) : pp 357.e1-7

Dates: Created 2009/09/30; Completed 2009/10/22; Revised 2009/10/28;

PMID: 19788967, status: MEDLINE (last retrieval date: 10/29/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentOn: Am J Obstet Gynecol. 2009 Oct;201(4):337-8. (PMID: 19788964)

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