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.

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 Maternal and foetal outcome in second stage caesarean section: a prospective study

2021 ◽  
Vol 10 (4) ◽  
pp. 1644
Author(s):  
Shuchi Sharma ◽  
Poojan Dogra ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Cervical Dilatation ◽  
Bladder Injury ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
A Prospective Study

Background: Caesarean section is the most commonly performed abdominal operation in women all over the world. Caesarean sections during the second stage labour accounts for approximately one fourth of all primary caesareans.  Caesarean section at full cervical dilatation is technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased haemorrhage and infection. Aims and objectives were to determine the indications, maternal and foetal morbidity associated with caesarean section in the second stage of labour.Methods: This prospective study included consecutive 50 cases of caesarean section deliveries conducted in second stage of labor for singleton live pregnancies at term. The data collected in the study was analyzed in terms of maternal demographics, indications of caesarean section, intra-operative and postoperative complications and neonatal outcomes.Results: In our series of 50 deliveries, arrest of descent of fetal head due to malposition was the most common indication of caesarean section accounting for 74% and average procedure time was 45-70 minutes. PPH (62%) was the most common complication. Bladder injury was found in 14% cases. Neonatal outcome variables like APGAR<3 at 5 minutes, respiratory distress and neonatal death were observed in 7, 26 and 2 deliveries respectively.Conclusions: Women undergoing cesarean section in second stage of labour are associated with increased maternal and fetal morbidity. They require special care and hence operation should ideally be performed and supervised by an experienced obstetrician. A proper judgement is required to take a decision for caesarean section at full cervical dilatation.

scholarly journals Feto-maternal outcome in second versus first stage caesarean delivery in a tertiary medical care centre

2018 ◽  
Vol 7 (12) ◽  
pp. 5084
Author(s):  
Nupur Gupta ◽  
Taru Gupta ◽  
Ritu Singh
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Maternal Outcomes ◽  
New Delhi ◽  
Perinatal Morbidity ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Obstetrics And Gynaecology ◽  
Nicu Admission ◽  
Febrile Morbidity

 Background: The aim is to study neonatal and maternal outcomes of the caesarean sections performed in first stage versus second stage of labour. Methods: The retrospective analysis of data were done of caesarean section done at Department of Obstetrics and Gynaecology at ESI PGIMSR Basaidarapur New Delhi between January 2016 to December 2016. 45 women, who underwent second stage caesarean section were studied. For each case, two consecutive cases, who underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury and postoperative complications. Results: Out of 4477 deliveries, 1466 had caesarean section with a rate of 32%. The rate of second stage caesarean section was 3% of total caesarean section and 1% of total deliveries. Second stage caesarean section had higher maternal and perinatal morbidity like atonic PPH (33.3%), lower uterine segment extension (7%), febrile morbidity (10%), and need for blood transfusion (15%). There were 15.5% NICU admission in second stage caesarean group while none in first stage group. Conclusions: Caesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing caesarean section in the second stage of the labour. They should be handled by senior and experienced obstetrician. Neonatologist should be present for every second stage caesarean section.

scholarly journals Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

2021 ◽  
Vol 10 (10) ◽  
pp. 3929
Author(s):  
Pravinkumar A. Jadav ◽  
Palak M. Dabhi ◽  
Dhruti A. Rathod
Keyword(s):  
Retrospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Transfusion Rate ◽  
Care Hospital ◽  
Intraoperative Complication ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.

scholarly journals Upright kneeling position during second stage of labor: a pilot study

2018 ◽  
Vol 7 (2) ◽  
pp. 401 ◽  
Author(s):  
Anjali Dabral ◽  
Pallavi Pawar ◽  
Rekha Bharti ◽  
Archana Kumari ◽  
Achla Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
North India ◽  
Care Hospital ◽  
Apgar Scores ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears ◽  
Second Stage Of Labour

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

scholarly journals Learning From Experience: Development of a Cognitive Task List to Perform a Caesarean Section in the Second Stage of Labour

2015 ◽  
Vol 37 (12) ◽  
pp. 1063-1071 ◽  
Author(s):  
Sorca O’Brien ◽  
Kalpana Sharma ◽  
Andrea Simpson ◽  
John Kingdom ◽  
Rory Windrim ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cognitive Task ◽  
Learning From Experience ◽  
Second Stage ◽  
Task List ◽  
Second Stage Of Labour

Case report of neonatal near drowning associated with underwater birth

2016 ◽  
Vol 5 (2) ◽  
pp. 139-140
Author(s):  
Sarah Wright ◽  
Mohamed E. Abdel-Latif
Keyword(s):  
Case Report ◽  
Water Immersion ◽  
Perinatal Morbidity ◽  
Near Drowning ◽  
Second Stage ◽  
The Third ◽  
Second Stage Of Labour ◽  
Increased Risk ◽  
Third Stage ◽  
Water Birth

Abstract Water immersion of labouring women during the first stage and second stage of labour significantly reduces analgesia requirements and increases women’s reported satisfaction with pushing, without adversely affecting labour duration, operative delivery rates, or foetal wellbeing. However, immersion during the third stage of labour is associated with potential serious complications that are not seen with land-based birth. Here, we present a case report of a baby born via water birth. The report illustrates increased risk of significant perinatal morbidity associated with water birth.

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