American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 357.e1-357.e7 , October 2009

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

Presented in part at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 29-31, 2009.

  • Dwight J. Rouse, MD

      Affiliations

    • Department of Obstetrics and Gynecology at the University of Alabama at Birmingham, Birmingham, AL
    • ,
  • Steven J. Weiner, MS

      Affiliations

    • Department of Obstetrics and Gynecology, The George Washington University Biostatistics Center, Washington, DC
    • ,
  • Steven L. Bloom, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
    • ,
  • Michael W. Varner, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT
    • ,
  • Catherine Y. Spong, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
    • ,
  • Susan M. Ramin, MD

      Affiliations

    • Department of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, Houston, TX
    • ,
  • Steve N. Caritis, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Alan M. Peaceman, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL
    • ,
  • Yoram Sorokin, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Anthony Sciscione, DO

      Affiliations

    • Department of Obstetrics and Gynecology, Drexel University, Philadelphia, PA
    • ,
  • Marshall W. Carpenter, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Brown University, Providence, RI
    • ,
  • Brian M. Mercer, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH
    • ,
  • John M. Thorp Jr, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC
    • ,
  • Fergal D. Malone, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Columbia University, New York, NY
    • ,
  • Margaret Harper, MD, MS

      Affiliations

    • Department of Obstetrics and Gynecology, Wake Forest University Health Sciences, Winston-Salem, NC
    • ,
  • Jay D. Iams, MD

      Affiliations

    • Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH
    • ,
  • Garland D. Anderson, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX
    • ,
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

Received 8 April 2009 ,Revised 13 July 2009 ,Accepted 10 August 2009.

References 

  1. Cohen WR. Influence of the duration of second stage labor on perinatal outcome and puerperal morbidity. Obstet Gynecol. 1977;49:266–269
  2. Moon JM, Smith CV, Rayburn WF. Perinatal outcome after a prolonged second stage of labor. J Reprod Med. 1990;35:229–231
  3. Menticoglou SM, Manning F, Harman C, Morrison I. Perinatal outcome in relation to second-stage duration. Am J Obstet Gynecol. 1995;173:906–912
  4. Janni W, Schiessl B, Peschers U, et al. The prognostic impact of a prolonged second stage of labor on maternal and fetal outcome. Acta Obstet Gynecol Scand. 2002;81:214–221
  5. O'Connell MP, Hussain J, MacLennan FA, Lindow SW. Factors associated with a prolonged second state of labour: a case-controlled study of 364 nulliparous labours. J Obstet Gynaecol. 2003;23:255–257
  6. Myles TD, Santolaya J. Maternal and neonatal outcomes in patients with a prolonged second stage of labor. Obstet Gynecol. 2003;102:52–58
  7. Cheng YW, Hopkins LM, Caughey AB. How long is too long: does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes?. Am J Obstet Gynecol. 2004;191:933–938
  8. Bloom SL, Spong CY, Thom E, et al. Fetal pulse oximetry and cesarean delivery. N Engl J Med. 2006;355:2195–2202
  9. American College of Obstetricians and Gynecologists. Dystocia and augmentation of labor: ACOG practice bulletin, no. 49. Obstet Gynecol. 2003;102:1445–1454
  10. Saunders NSG, Paterson CM, Wadsworth J. Neonatal and maternal morbidity in relation to the length of the second stage of labour. BJOG. 1992;99:381–385
  11. Rouse DJ, Owen J, Goldenberg RL, Cliver SP. The effectiveness and costs of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound. JAMA. 1996;276:1480–1486

 Cite this article as: Rouse DJ, Weiner SJ, Bloom SL, et al. Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes. Am J Obstet Gynecol 2009;201:357.e1-7.

 Reprints not available from the authors

 Supported by Grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD21410, HD27860, HD27869, HD27915, HD27917, HD34116, HD34136, HD34208, HD40485, HD40500, HD40512, HD40544, HD40545, HD40560, and HD36801).

PII: S0002-9378(09)00900-4

doi: 10.1016/j.ajog.2009.08.003

American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 357.e1-357.e7 , October 2009

Article Tools