Prolonged second stage of labour including difficult decision-making on operative vaginal delivery and caesarean section

2010 ◽  
pp. 84-92
Author(s):  
Hajeera Butt ◽  
Deirdre J. Murphy
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Difficult Decision ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Operative Vaginal Delivery

scholarly journals Does the length of second stage of labour or second stage caesarean section in nulliparous women increase the risk of preterm birth in subsequent pregnancies?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Cathy Z. Liu ◽  
Nicole Ho ◽  
Keisuke Tanaka ◽  
Christoph Lehner ◽  
Renuka Sekar ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Subsequent Pregnancy ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Index Pregnancy ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Significant Difference

AbstractShort communicationThis study aimed to investigate the role of prolonged second stage of labour and second stage caesarean section on the risk of spontaneous preterm birth (sPTB) in a subsequent pregnancy.Objectives and MethodsThis was a retrospective cohort study of nulliparous women with two consecutive singleton deliveries between 2014 and 2017 at a tertiary centre. In the vaginal delivery cohort, subsequent pregnancy outcomes for women with a prolonged second stage (>2 h) were compared with those with a normal second stage (≤2 h). In the caesarean delivery cohort, women with a first stage or a second stage were compared with the vaginal delivery cohort. The primary outcome was subsequent sPTB.ResultsA total of 821 women met inclusion criteria, of which 74.8% (614/821) delivered vaginally and 25.2% (207/821) delivered by caesarean section. There was no association between a prolonged second stage in the index pregnancy and subsequent sPTB (aOR 0.70, 95% CI 0.13–3.83, p=0.7). The risk of subsequent sPTB was threefold for those with a second stage caesarean section; however this did not reach statistical significance.ConclusionsA prolonged second stage of labour in the index pregnancy is not associated with an increased risk of subsequent sPTB. A second stage caesarean section in the index pregnancy may be associated with an increased risk of subsequent sPTB, however there was no statistically significant difference. These findings are important for counseling and suggest that the effects of these factors are not clinically significant to justify additional interventions in the subsequent pregnancy.

scholarly journals Determinants and Outcomes of Emergency Caesarean Section following Failed Instrumental Delivery: 5-Year Observational Review at a Tertiary Referral Centre in London

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sian McDonnell ◽  
Edwin Chandraharan
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Emergency Caesarean Section ◽  
Vaginal Birth ◽  
Instrumental Delivery ◽  
Tertiary Referral Centre ◽  
Emergency Caesarean ◽  
Second Stage Of Labour ◽  
Operative Vaginal Delivery ◽  
Fetal Complications

Objectives. To review the determinants for a failed operative vaginal delivery and to examine associated fetal and maternal morbidity.Design. Retrospective observational study.Setting. Large London Teaching Hospital.Method. A retrospective review of case notes during a 5-year period was carried out.Results. Overall 119 women (0.44%) out of 26,856 births had a caesarean section following a failed instrumental delivery, which comprised 5.1% of all operative vaginal births. 73% had a spontaneous onset of labour and 63% required syntocinon at some time prior to delivery. 71.5% of deliveries were complicated by malposition. Only 20% of deliveries were attended by a consultant obstetrician. Almost 50% of women and 8.4% of neonates sustained trauma at the time of either their failed instrumental delivery or the caesarean section.Conclusions. Emergency caesarean section during the second stage of labour is associated with maternal and fetal complications. A ‘failed instrumental delivery score’ (FIDS) may aid practitioners in predicting an increased likelihood of a failed operative vaginal birth and therefore to consider a trial of operative vaginal delivery in the theatre. Senior input should also be sought because a failed operative vaginal birth is associated with increased maternal and fetal morbidity.

scholarly journals Rising rates of second stage caesarean section and its impact on maternal outcome

2018 ◽  
Vol 7 (7) ◽  
pp. 2681
Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Adverse Outcomes ◽  
Cesarean Sections ◽  
Maternal Complications ◽  
College Hospital ◽  
Second Stage Of Labor ◽  
Medical College ◽  
Second Stage ◽  
Second Stage Of Labour

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.

scholarly journals Management of prolonged second stage of labor

2018 ◽  
Vol 7 (7) ◽  
pp. 2527
Author(s):  
Sanjay Singh ◽  
Uttara Aiyer Kohli ◽  
Shakti Vardhan
Keyword(s):  
Caesarean Section ◽  
Perinatal Morbidity ◽  
Management Options ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Definition Of

Second stage of labour has been often neglected leading to increased maternal and perinatal morbidity. Recognising and managing prolonged second stage is a challenge even to an experienced obstetrician. This article reviews the changes in the definition of prolonged second stage over the years. It discusses the causes, recognition and management options along with the difficulties in delivering a patient with prolonged second stage of labour. Though adding an extra hour to the definition of second stage in patients may reduce the rate of caesarean section but some studies also show a rise in maternal and perinatal morbidity. Obstetricians are familiarized to the different techniques of delivery of the impacted head. Once diagnosis of prolonged second stage is confirmed, causes should be identified and addressed, and treatment should be individualised, and timing and mode of intervention planned.

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