Affordable Access

Publisher Website

Prolonged second stage of labor: Predictors of adverse maternal and perinatal outcomes in a sub-Saharan setting.

Authors
  • Hyredin, Tofike1
  • Urgie, Tadesse1
  • Sium, Abraham Fessehaye1
  • 1 Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. , (Ethiopia)
Type
Published Article
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
Publication Date
Dec 01, 2023
Volume
163
Issue
3
Pages
997–1004
Identifiers
DOI: 10.1002/ijgo.14982
PMID: 37417324
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To determine the predictors of adverse maternal and perinatal outcomes among parturients with prolonged second stage of labor. This study is a cross-sectional study of women with prolonged second stage of labor from January 1 to June 30, 2021, in four tertiary hospitals in Ethiopia. Data were collected prospectively using a structured questionnaire. Descriptive statistics were used to analyze baseline characteristics. Bivariate and multivariate logistic regression analyses were applied to determine predictors of adverse maternal and perinatal outcomes. A total of 406 women were included in the study. More than half (25/46, 54%) of the women with a prolonged second stage of 4 h or longer had vaginal delivery, which was lower than the 73% (140/190) of women who had a second stage of 2-3 h and the 63.4% (64/101) of women with a second stage duration of 3-4 h. Duration of second stage of labor was not a predictor of composite adverse maternal outcomes nor was it a predictor of adverse perinatal outcome. Operative vaginal delivery (adjusted odds ratio [aOR] 6.0, 95% confidence interval [CI] 2.41-14.9) and nulliparity (aOR 4.1, 95% CI 1.58-10.41) were predictors of adverse maternal outcome, but nulliparity (aOR 1.8, 95% CI 1.05-3.04) and duration of rupture of membranes greater than 18 h (aOR 2.4, 95% CI 1.21-4.93) were predictors of adverse perinatal outcomes. Under strict fetal and maternal well-being monitoring, women with a prolonged second stage of labor can labor for an additional 2 h (up to a total of 4 h) without increasing adverse maternal and neonatal outcomes. © 2023 International Federation of Gynecology and Obstetrics.

Report this publication

Statistics

Seen <100 times