Second-Stage Labor Duration in Nulliparous Women

AbstractObjectivesShort interpregnancy intervals (IPI) have been linked to multiple adverse maternal and neonatal outcomes, but less is known about prolonged IPI, including its relationship with labor progression. The objective of the study was to investigate whether prolonged IPIs are associated with longer second stages of labor.MethodsA perinatal database from Kaiser Permanente Hawaii was used to identify 442 women with a prolonged IPI ≥60 months. Four hundred forty two nulliparous and 442 multiparous women with an IPI 18–59 months were selected as comparison groups. The primary outcome was second stage of labor duration. Perinatal outcomes were compared between these groups.ResultsThe median (IQR) second stage of labor duration was 76 (38–141) min in nulliparous women, 15 (9–28) min in multiparous women, and 18 (10–38) min in women with a prolonged IPI (p<0.0001). Pairwise comparisons revealed significantly different second stage duration in the nulliparous group compared to both the multiparous and prolonged IPI groups, but no difference between the multiparous and prolonged IPI groups. There was a significant association with the length of the IPI; median duration 30 (12–61) min for IPI ≥120 months vs. 15 (9–27) min for IPI 18–59 months and 16 (9–31) min for IPI 60–119 months (p=0.0014).ConclusionsThe second stage of labor did not differ in women with a prolonged IPI compared to normal multiparous women. Women with an IPI ≥120 months had a significantly longer second stage vs. those with a shorter IPI. These findings provide a better understanding of labor progression in pregnancies with a prolonged IPI.

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An Analysis of Second-Stage Labor beyond 3 Hours in Nulliparous Women

American Journal of Perinatology ◽

10.1055/s-0032-1314894 ◽

2012 ◽

Vol 29 (09) ◽

pp. 717-722 ◽

Cited By ~ 24

Author(s):

April Bleich ◽

James Alexander ◽

Donald McIntire ◽

Kenneth Leveno

Keyword(s):

Second Stage ◽

Nulliparous Women ◽

Second Stage Labor

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890: Maternal and neonatal outcomes by parity and second-stage labor duration

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2016.11.799 ◽

2017 ◽

Vol 216 (1) ◽

pp. S508-S509 ◽

Cited By ~ 2

Author(s):

Dotun Ogunyemi ◽

Perry Friedman ◽

Andrew Jovanovski ◽

Ishani Shah ◽

Natalie Hage ◽

...

Keyword(s):

Neonatal Outcomes ◽

Second Stage ◽

Labor Duration ◽

Maternal And Neonatal Outcomes ◽

Second Stage Labor

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Effect of Labor Camera on the Duration of the Second Stage Labor in Primipara

Global Medical & Health Communication (GMHC) ◽

10.29313/gmhc.v9i2.6993 ◽

2021 ◽

Vol 9 (2) ◽

Author(s):

Yetti Purnama ◽

Kurnia Dewiani ◽

Linda Yusanti

Keyword(s):

Intervention Group ◽

Total Sample ◽

Labor Process ◽

Control Group ◽

Chi Square ◽

Control Group Design ◽

Group Design ◽

Second Stage ◽

Labor Duration ◽

Second Stage Labor

Fear and anxiety due to severe labor pains could also lead to prolonged labor. The efforts made to accelerate the second stage labor process are by providing emotional support with the support of a labor camera. The mother is allowed to observe the development state of her baby's head through video on a tablet or laptop screen. Furthermore, the mother's emotional level becomes more provoked and motivated to strain the labor process faster. This study aims to determine the effect of the labor cameras on the second state duration in primiparous. The design of this study was a posttest-only control group design experiment with a total sample of 30 primiparous of the second stage at independent midwife practice in Bengkulu city in November–December 2020. Each group consisted of 15 for treatment (with labor cameras) and 15 for control (without labor cameras)—the assessment of the labor duration by counting the labor time in seconds during the second state. The statistical results using the t test and chi-square test analysis showed that the intervention group's labor duration (1,393.3 seconds) was shorter than the control group's (2,340.6 seconds). The mean difference in the delivery time was 947.3 seconds or 15.7 minutes faster in the intervention group than in the control group. In conclusion, using a labor camera on the labor duration of the second stage in primiparous mothers is an effect of using a labor camera. PENGARUH KAMERA PERSALINAN TERHADAP DURASI PERSALINAN KALA II PADA PRIMIPARARasa takut dan cemas akibat nyeri persalinan yang berat juga dapat menyebabkan partus lama. Salah satu upaya yang dilakukan untuk mempercepat proses kala II persalinan adalah memberikan dukungan emosional dengan bantuan kamera persalinan. Ibu diberi kesempatan untuk melihat perkembangan pengeluaran kepala bayinya melalui video pada layar tablet atau laptop sehingga tingkat emosional ibu menjadi lebih terbangun dan termotivasi untuk mempercepat proses persalinan. Penelitian ini bertujuan mengetahui pengaruh kamera persalinan terhadap durasi persalinan kala II pada primipara. Desain penelitian adalah eksperimen posttest-only control group design dengan jumlah sampel 30 primipara kala II di bidan praktik mandiri Kota Bengkulu pada November–Desember 2020. Tiap-tiap kelompok berjumlah 15 untuk kelompok perlakuan (menggunakan kamera persalinan) dan 15 untuk kontrol (tidak menggunakan kamera persalinan). Penilaian durasi persalinan dengan menghitung detik selama kala II berlangsung. Pengujian statistik menggunakan analisis uji t dan uji chi-square menunjukkan bahwa durasi persalinan kelompok perlakuan (1.393,3 detik) lebih singkat daripada kelompok kontrol (2.340,6 detik). Selisih perbedaan waktu persalinan rerata selama 947,3 detik atau 15,7 menit lebih cepat pada kelompok intervensi dibanding dengan kelompok kontrol. Simpulan, terdapat pengaruh penggunaan kamera persalinan terhadap durasi persalinan kala II pada ibu primipara.

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A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor

Anesthesiology ◽

10.1097/aln.0000000000000454 ◽

2015 ◽

Vol 122 (1) ◽

pp. 172-177 ◽

Cited By ~ 8

Author(s):

Margaret G. Craig ◽

Erica N. Grant ◽

Weike Tao ◽

Donald D. McIntire ◽

Kenneth J. Leveno

Keyword(s):

Mode Of Delivery ◽

Group Versus ◽

Postnatal Period ◽

Neonatal Outcomes ◽

Motor Blockade ◽

Second Stage Of Labor ◽

Second Stage ◽

Nulliparous Women ◽

Epidural Bupivacaine ◽

Second Stage Labor

Abstract Background: The purpose of this prospective, double-blinded, parallel-arm, randomized trial was to examine the effects of epidural bupivacaine on the length of the second stage of labor in nulliparous women. Methods: The authors assessed length of second-stage labor, degree of motor blockade, mode of delivery, and visual analog scores in 310 nulliparous women with labor epidurals randomized to receive either: (1) 0.125% bupivacaine and fentanyl 2 μg/ml or (2) fentanyl 10 μg/ml alone via epidural using double blinding. Results: The median duration of the second stage was 75 min (41, 128) in the bupivacaine/fentanyl group versus 73 min (42, 120) in the fentanyl-only group (P = 0.17) with a median difference of 6.0 (95% CI, −6.0 to 18.0). Furthermore, there was no difference in degree of motor blockade, incidence of operative delivery, visual analog scores, or neonatal outcomes between the two groups. No adverse events were reported. Conclusions: Use of epidural bupivacaine/fentanyl or a fentanyl-only infusion during the second stage of labor did not affect the duration of the second stage of labor, degree of motor blockade, mode of delivery, pain relief, and maternal or neonatal outcomes. However, in the fentanyl-only infusion group, there was a fivefold increase in opioid exposure to the fetus with unknown effects on neurobehavior, an outcome not assessed beyond the immediate postnatal period in this study.

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