Prolonged second stage of labour increases maternal morbidity but not neonatal morbidity

2018 ◽  
Vol 59 (4) ◽  
pp. 555-560 ◽  
Author(s):  
Payal Matta ◽  
Jessica Turner ◽  
Christopher Flatley ◽  
Sailesh Kumar
Keyword(s):  
Maternal Morbidity ◽  
Neonatal Morbidity ◽  
Second Stage ◽  
Second Stage Of Labour

scholarly journals Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

2021 ◽  
Vol 10 (10) ◽  
pp. 3929
Author(s):  
Pravinkumar A. Jadav ◽  
Palak M. Dabhi ◽  
Dhruti A. Rathod
Keyword(s):  
Retrospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Transfusion Rate ◽  
Care Hospital ◽  
Intraoperative Complication ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.

scholarly journals Obesity, Second Stage Duration, and Labor Outcomes in Nulliparous Women

2019 ◽  
Author(s):  
Antonina I. Frolova ◽  
Nandini Raghuraman ◽  
Molly J. Stout ◽  
Methodius G. Tuuli ◽  
George A. Macones ◽  
...  
Keyword(s):  
Maternal Morbidity ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Obese Women ◽  
Stage Duration ◽  
Second Stage ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Labor Outcomes

Abstract Objective To estimate second stage duration and its effects on labor outcomes in obese versus nonobese nulliparous women. Study Design This was a secondary analysis of a cohort of nulliparous women who presented for labor at term and reached complete cervical dilation. Adjusted relative risks (aRR) were used to estimate the association between obesity and second stage characteristics, composite neonatal morbidity, and composite maternal morbidity. Effect modification of prolonged second stage on the association between obesity and morbidity was assessed by including an interaction term in the regression model. Results Compared with nonobese, obese women were more likely to have a prolonged second stage (aRR: 1.48, 95% CI: 1.18–1.85 for ≥3 hours; aRR: 1.65, 95% CI: 1.18–2.30 for ≥4 hours). Obesity was associated with a higher rate of second stage cesarean (aRR: 1.78, 95% CI: 1.34–2.34) and cesarean delivery for fetal distress (aRR: 2.67, 95% CI: 1.18–3.58). Obesity was also associated with increased rates of neonatal (aRR: 1.38, 95% CI: 1.05–1.80), but not maternal morbidity (aRR: 1.06, 95% CI: 0.90–1.25). Neonatal morbidity risk was not modified by prolonged second stage. Conclusion Obesity is associated with increased risk of neonatal morbidity, which is not modified by prolonged second stage of labor.

scholarly journals Vulvovaginal Infralevator Haematoma Mimicking the Second Stage of Labour

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
J. O. Awoleke ◽  
O. M. Ipinnimo
Keyword(s):  
Blood Loss ◽  
Tissue Damage ◽  
Maternal Morbidity ◽  
Perineal Pain ◽  
Rare Occurrence ◽  
Risk Of Infection ◽  
Final Size ◽  
Rare Presentation ◽  
Second Stage ◽  
Second Stage Of Labour

Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful “bearing down” efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection. Management is generally conservative for small collections, but surgery is indispensable when they acutely expand in size or are large with worsening symptoms.

Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study

The Lancet ◽  
2001 ◽  
Vol 358 (9289) ◽  
pp. 1203-1207 ◽  
Author(s):  
Deirdre J Murphy ◽  
Rachel E Liebling ◽  
Lisa Verity ◽  
Rebecca Swingler ◽  
Roshni Patel
Keyword(s):  
Cohort Study ◽  
Neonatal Morbidity ◽  
Operative Delivery ◽  
Second Stage ◽  
Second Stage Of Labour

Early Maternal and Neonatal Morbidity Associated With Operative Delivery in Second Stage of Labour: A Cohort Study

2002 ◽  
Vol 57 (4) ◽  
pp. 199-200
Author(s):  
Deirdre J. Murphy ◽  
Rachel E. Liebling ◽  
Lisa Verity ◽  
Rebecca Swingler ◽  
Roshni Patel
Keyword(s):  
Cohort Study ◽  
Neonatal Morbidity ◽  
Operative Delivery ◽  
Second Stage ◽  
Second Stage Of Labour

Neonatal and Maternal Morbidity in Relation to the Length of the Second Stage of Labour

1993 ◽  
Vol 48 (1) ◽  
pp. 20-21
Author(s):  
NIGEL ST. G. SAUNDERS ◽  
CATHERINE M. PATERSON ◽  
JANE WADSWORTH
Keyword(s):  
Maternal Morbidity ◽  
Second Stage ◽  
Second Stage Of Labour

scholarly journals Caesarean section in second stage of labour: a commentary on principles and techniques

2021 ◽  
Vol 10 (10) ◽  
pp. 4038
Author(s):  
Michael S. Archibong ◽  
Wilson S. Adenikinju ◽  
Olaniyi J. Olayemi ◽  
Mariam Amuda
Keyword(s):  
Caesarean Section ◽  
Maternal Morbidity ◽  
Cervical Dilatation ◽  
Second Stage ◽  
Second Stage Of Labour

Caesarean section done at full cervical dilatation (second stage of labour) has been on the rise globally and comes with its own unique challenges and complications. This commentary highlights the peculiar challenges associated with caesarean section in second stage of labour and gives an overview on various principles to be followed and techniques to employ to reduce fetal and maternal morbidity.

scholarly journals Relationship between the Duration of the Second Stage of Labour and Neonatal Morbidity

2019 ◽  
Vol 8 (3) ◽  
pp. 376
Author(s):  
Nuria Infante-Torres ◽  
Milagros Molina-Alarcón ◽  
Juan Gómez-Salgado ◽  
Julián Rodríguez-Almagro ◽  
Ana Rubio-Álvarez ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Neonatal Resuscitation ◽  
Binary Logistic Regression ◽  
Neonatal Morbidity ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Increased Risk ◽  
Multiparous Women ◽  
Potential Risk Factors

(1) Background: To assess the relationship between the duration of the second stage of labour and the neonatal morbidity risk; (2) Methods: An observational, analytical, retrospective cohort study was performed at the “Mancha-Centro” Hospital (Spain) during the 2013–2016 period. Data were collected from 3863 women who gave a vaginal birth. The studied neonatal morbidity variables were umbilical cord arterial pH, 5-min Apgar score, need for advanced neonatal resuscitation, and a composite neonatal morbidity variable on which the multivariate analysis was done. A univariate analysis was used for the potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors; (3) Results: The univariate analysis showed a statistically significant relationship between the duration of the second stage of labour and a high risk of advanced neonatal resuscitation and composite neonatal morbidity in multiparous women. However, after performing the multivariate analysis for the variable “composite neonatal morbidity”, we observed no relationship with the duration of the second stage of labour in either nulliparous or multiparous women; (4) Conclusions: The duration of the second stage of labour was not related to an increased risk of neonatal morbidity in our study population.

scholarly journals Maternal and neonatal outcomes in vacuum assisted births in the government tertiary care hospital in Mandya: a retrospective record-based study

2020 ◽  
Vol 9 (3) ◽  
pp. 965
Author(s):  
Shwetha M. ◽  
Shilpa M. N.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Vacuum Extraction ◽  
Care Hospital ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Vaginal Deliveries ◽  
Assisted Delivery ◽  
The Government

Background: Vacuum extraction and forceps are the two options when an instrument is needed to facilitate a vaginal birth. Vacuum extraction has recently gained popularity because of new designs of vacuum cups with reduced risk of injury to the neonate. Vacuum extraction is one of the evidence-based interventions that can prevent complications by shortening the second stage of labour. The present study has been carried out to evaluate the maternal and neonatal morbidity, mortality and failure associated with vacuum assisted vaginal deliveries, at a Government tertiary care hospital in Mandya, Karnataka, India.Methods: The study was a record-based study including a total of 207 women who underwent vaginal assisted delivery in the form of vacuum assisted deliveries in a period of 6 months from January 2019 to June 2019 at the Government tertiary care hospital in Mandya, Karnataka, India. Records of women who had vacuum assisted deliveries and records of their newborn children were accessed.Results: In our study 41.5% of the subjects were in the age group of 21-25 years. Nearly 3/4th (74.4%) of the subjects were primigravida. More than half (54.1%) of the study subjects had to be put under vacuum assisted techniques for delivery because of the prolonged second stage of labour, failure rate was 0.4%. Out of 207 vacuum assisted deliveries maternal complication rate was 8.21%, 17.3% neonates had NICU admission and 14.97% had perinatal complications.Conclusions: Vacuum assisted vaginal delivery is comparatively a better choice in preventing the complications caused due to prolonged second stage of labour thus reducing the cesareans rate. It is a safe alternative to cesareans delivery in rightly chosen case. Vacuum assisted delivery by a skilled person and a proper technique is associated with lesser maternal and neonatal morbidity.

scholarly journals A study on the role of partograph in monitoring labour in high risk pregnancies

2019 ◽  
Vol 6 (4) ◽  
pp. 1326
Author(s):  
Sushreesmita Mohanty ◽  
Ipsita Mohanty
Keyword(s):  
High Risk ◽  
Maternal Morbidity ◽  
Risk Groups ◽  
Medical College ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Risk Patients ◽  
The Mean ◽  
Early Detection And Prevention

Background: The progress of labour can be graphically represented using the WHO partogragh, which helps in early detection and prevention of complication of labour, thus resulting in a better feto-maternal outcome especially in high risk cases.Methods: The study was undertaken at Hitech Medical College and Hospital, Bhubaneswar from March 2017 to February 2019 on 200 high risk patients. The progress of labour was plotted and assessed on Modified WHO partograph.Results: Majority of the cases were referred cases. Augmentation of labour was carried out in 56 cases. The mean duration of labour in the first stage was 5.4 hours and 4.1 hours in primi and multigravidas, whereas that of the second stage of labour are 37.5 minutes and 26.3 minutes respectively. 51 cases had prolonged labour and 15 cases had arrest of labour in the second stage. Maximum number of cases underwent LSCS due to abnormal labour progression. 8.7% of the cases had PPH and 2.3% had puerperal sepsis. Neonatal asphyxia was seen in 13.6% cases and 2.8% had early neonatal death.Conclusion: The results conclude that the WHO modified partograph is an inexpensive useful tool in monitoring the progress of labour and reducing foeto maternal morbidity in high risk groups.

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