Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Second-Stage Duration of Labor & Morbidity Risk

Obstet Gynecol; ePub 2018 Jan 9; Grantz, et al

In nulliparous women, rates of spontaneous vaginal birth without serious morbidity steadily decreased for increasing second-stage duration, expect for the first half hour. This according to a retrospective cohort study that assessed the morbidity associated with continuing the second-state duration of labor, weighing the probability of spontaneous vaginal birth without morbidity vs birth with serious maternal or neonatal complications. The cohort included singleton, vertex births at ≥36 weeks of gestation without prior cesarean delivery in 43,810 nulliparous and 59,605 multiparous women. Researchers found:

  • Rates of spontaneous vaginal birth without morbidity were slightly higher after the first half hour for nulliparous women; rates then decreased with increasing second-stage duration.
  • Rates of spontaneous vaginal birth without morbidity decreased with increasing second-stage duration in multiparous women.
  • There was no inflection point at a particular hour mark for either spontaneous vaginal delivery without morbidity or births with morbidity.

Citation:

Grantz KL, Sundaram R, Ma L, et al. Reassessing the duration of the second stage of labor in relation to maternal and neonatal morbidity. [Published online ahead of print January 9, 2018]. Obstet Gynecol. doi:10.1097/AOG.0000000000002431.

This Week's Must Reads

Infection Prevention After Gynecologic Procedures, Obstet Gynecol; ePub 2018 Jun; Soper, Chelmow, et al

Treatment Update for Polycystic Ovary Syndrome, Obstet Gynecol; ePub 2018 Jun; Legro, et al

Preconception Vitamin D Key After Pregnancy Loss, Lancet Diabetes Endocrinol; ePub 2018 May 30; Mumford, et al

Hysterectomy Performed by Very Low-Volume Surgeons, Obstet Gynecol; ePub 2018 May 7; Ruiz, et al

Place of Death in Patients with Gynecologic Cancer, Obstet Gynecol; ePub 2018 May 7; Hicks-Courant, et al

Must Reads in Obstetrics

Preconception Vitamin D Key After Pregnancy Loss, Lancet Diabetes Endocrinol; ePub 2018 May 30; Mumford, et al

PA & Risk of Preterm Birth in African American Women, Women’s Health Issues; ePub 2018 May 7; Straughen, et al

ACOG On Optimizing Postpartum Care, Obstet Gynecol; ePub 2018 May; Stuebe, et al

Cesarean Delivery Rates in the US , Am J Obstet Gynecol; ePub 2018 Apr 12; Hehir, et al

Perinatal Outcomes in Women with Chronic Hypertension, Obstet Gynecol; ePub 2018 Apr 6; Youngstrom, et al