Second-stage labor duration in nulliparous women

relationship to maternal and perinatal outcomes

Dwight J. Rouse, Steven J. Weiner, Steven L. Bloom, Michael W. Varner, Catherine Y. Spong, Susan M. Ramin, Steve N. Caritis, Alan M. Peaceman, Yoram Sorokin, Anthony Sciscione, Marshall W. Carpenter, Brian M. Mercer, John M. Thorp, Fergal D. Malone, Margaret Harper, Jay D. Iams, Garland D. Anderson

Research output: Contribution to journalArticle

89 Citations (Scopus)

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 ≥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.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume201
Issue number4
DOIs
StatePublished - Oct 2009

Fingerprint

Second Labor Stage
Mothers
Uterine Inertia
Odds Ratio
Chorioamnionitis
Oximetry
Lacerations
Neonatal Intensive Care Units

Keywords

  • duration
  • nulliparous women
  • second stage of labor

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Second-stage labor duration in nulliparous women : relationship to maternal and perinatal outcomes. / Rouse, Dwight J.; Weiner, Steven J.; Bloom, Steven L.; Varner, Michael W.; Spong, Catherine Y.; Ramin, Susan M.; Caritis, Steve N.; Peaceman, Alan M.; Sorokin, Yoram; Sciscione, Anthony; Carpenter, Marshall W.; Mercer, Brian M.; Thorp, John M.; Malone, Fergal D.; Harper, Margaret; Iams, Jay D.; Anderson, Garland D.

In: American Journal of Obstetrics and Gynecology, Vol. 201, No. 4, 10.2009.

Research output: Contribution to journalArticle

Rouse, DJ, Weiner, SJ, Bloom, SL, Varner, MW, Spong, CY, Ramin, SM, Caritis, SN, Peaceman, AM, Sorokin, Y, Sciscione, A, Carpenter, MW, Mercer, BM, Thorp, JM, Malone, FD, Harper, M, Iams, JD & Anderson, GD 2009, 'Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes', American Journal of Obstetrics and Gynecology, vol. 201, no. 4. https://doi.org/10.1016/j.ajog.2009.08.003
Rouse, Dwight J. ; Weiner, Steven J. ; Bloom, Steven L. ; Varner, Michael W. ; Spong, Catherine Y. ; Ramin, Susan M. ; Caritis, Steve N. ; Peaceman, Alan M. ; Sorokin, Yoram ; Sciscione, Anthony ; Carpenter, Marshall W. ; Mercer, Brian M. ; Thorp, John M. ; Malone, Fergal D. ; Harper, Margaret ; Iams, Jay D. ; Anderson, Garland D. / Second-stage labor duration in nulliparous women : relationship to maternal and perinatal outcomes. In: American Journal of Obstetrics and Gynecology. 2009 ; Vol. 201, No. 4.
@article{1c1fff45a3954ae2aee6f2f984388a11,
title = "Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes",
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 ≥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.",
keywords = "duration, nulliparous women, second stage of labor",
author = "Rouse, {Dwight J.} and Weiner, {Steven J.} and Bloom, {Steven L.} and Varner, {Michael W.} and Spong, {Catherine Y.} and Ramin, {Susan M.} and Caritis, {Steve N.} and Peaceman, {Alan M.} and Yoram Sorokin and Anthony Sciscione and Carpenter, {Marshall W.} and Mercer, {Brian M.} and Thorp, {John M.} and Malone, {Fergal D.} and Margaret Harper and Iams, {Jay D.} and Anderson, {Garland D.}",
year = "2009",
month = "10",
doi = "10.1016/j.ajog.2009.08.003",
language = "English (US)",
volume = "201",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Second-stage labor duration in nulliparous women

T2 - relationship to maternal and perinatal outcomes

AU - Rouse, Dwight J.

AU - Weiner, Steven J.

AU - Bloom, Steven L.

AU - Varner, Michael W.

AU - Spong, Catherine Y.

AU - Ramin, Susan M.

AU - Caritis, Steve N.

AU - Peaceman, Alan M.

AU - Sorokin, Yoram

AU - Sciscione, Anthony

AU - Carpenter, Marshall W.

AU - Mercer, Brian M.

AU - Thorp, John M.

AU - Malone, Fergal D.

AU - Harper, Margaret

AU - Iams, Jay D.

AU - Anderson, Garland D.

PY - 2009/10

Y1 - 2009/10

N2 - 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 ≥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.

AB - 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 ≥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.

KW - duration

KW - nulliparous women

KW - second stage of labor

UR - http://www.scopus.com/inward/record.url?scp=70349330016&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349330016&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2009.08.003

DO - 10.1016/j.ajog.2009.08.003

M3 - Article

VL - 201

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 4

ER -