Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes
Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes
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DOI：
10.1016/j.ajog.2009.08.003
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发表时间：
2009-10-01
影响因子：
9.8
通讯作者：
Anderson, Garland D.
中科院分区：
文献类型：
--
作者：
Rouse, Dwight J.;Weiner, Steven J.;Anderson, Garland D.
目的：本研究的目的是评估第二产程持续时间对产妇和围产儿结局的影响。研究设计：我们评估了参加胎儿脉搏血氧饱和度试验的未分娩产妇的结局。结果：在5341名参与者中，4126名进入第二产程。随着第二产程持续时间的延长，自然阴道分娩率下降，从第一产程1小时的85%下降到第二产程=5小时的9%。与第二产程持续时间显著相关的不良产妇结局包括绒毛膜羊膜炎(总发生率，3.9%)、会三度或四度撕裂(总发生率，8.7%)和子宫无力(总发生率，3.9%)。第二产程每增加一个小时的优势比在1.3-1.8之间。在个别不良新生儿结局中，只有进入新生儿重症监护病房与第二产程显著相关(优势比，1.4)。结论：第二产程不需要单独终止产程。
OBJECTIVE: The purpose of this study was to assess maternal and perinatal outcomes as a function of second-stage labor duration.STUDY DESIGN: We assessed outcomes in nulliparous laboring women who were enrolled in a trial of fetal pulse oximetry.RESULTS: Of 5341 participants, 4126 women reached the second stage of labor. As the duration of the second stage increased, spontaneous vaginal delivery rates declined, from 85% when the duration was < 1 hour to 9% when it was >= 5 hours. Adverse maternal outcomes that were associated significantly with the duration of the second stage of labor included chorioamnionitis (overall rate, 3.9%), third-or fourth-degree perineal laceration (overall rate, 8.7%), and uterine atony (overall rate, 3.9%). Odds ratios for each additional hour of the second stage of labor ranged from 1.3-1.8. Among individual adverse neonatal outcomes, only admission to a neonatal intensive care unit was associated significantly with second stage duration (odds ratio, 1.4).CONCLUSION: The second stage of labor does not need to be terminated for duration alone.