Defining an abnormal first stage of labor based on maternal and neonatal outcomes

American Journal of Obstetrics and Gynecology
Lorie M HarperAlison G Cahill

Abstract

The objective of the study was to determine the threshold for defining abnormal labor that is associated with adverse maternal and neonatal outcomes. This study consisted of a retrospective cohort of all consecutive women admitted at a gestation of 37.0 weeks or longer from 2004 to 2008 who reached the second stage of labor. The 90th, 95th, and 97th percentiles for progress in the first stage of labor were determined specific for parity and labor onset. Women with a first stage above and below each centile were compared. Maternal outcomes were cesarean delivery in the second stage, operative delivery, prolonged second stage, postpartum hemorrhage, and maternal fever. Neonatal outcomes were a composite of the following: admission to level 2 or 3 nursery, 5 minute Apgar less than 3, shoulder dystocia, arterial cord pH of less than 7.0, and a cord base excess of -12 or less. Of the 5030 women, 4534 experienced first stage of less than the 90th percentile, 251 between the 90th and 94th percentiles, 102 between the 95th and 96th percentiles, and 143 at the 97th percentile or greater. Longer labors were associated with an increased risk of a prolonged second stage, maternal fever, the composite neonatal outcome, shoulder dystocia, an...Continue Reading

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May 10, 2012·Obstetrics and Gynecology·Lorie M HarperAlison G Cahill
Aug 24, 2012·Obstetrics and Gynecology·Shayna M NormanAlison G Cahill

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Citations

Jan 24, 2015·American Journal of Health Promotion : AJHP·Maria PeralesRuben Barakat
Jun 28, 2015·American Journal of Obstetrics and Gynecology·Martina MurphyMichael Robson
Mar 19, 2015·Journal of Midwifery & Women's Health·Aaron B Caughey
Oct 16, 2015·Journal of Midwifery & Women's Health·Jeremy L NealAngela M Wilson-Liverman
Jan 31, 2015·American Journal of Obstetrics and Gynecology·Janine E SpainAlison G Cahill
Mar 3, 2015·American Journal of Obstetrics and Gynecology·Yen N TruongYvonne W Cheng
Mar 31, 2015·Gynécologie, obstétrique & fertilité·G Kayem
Jul 3, 2015·British Journal of Sports Medicine·Ruben BarakatAlejandro Lucia
Jul 9, 2017·Journal of Perinatal Medicine·Jana JuhasovaNina Kimmich
Nov 3, 2017·The Journal of Obstetrics and Gynaecology Research·Jila AgahSedigheh Borna
Jun 9, 2016·Obstetrics and Gynecology·Jonas G Wilson-LeedyJaimey M Pauli
Sep 5, 2018·Journal of Perinatal Medicine·Katharina RedlingIrene Hoesli
Feb 13, 2019·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·İlkay BozMehmet Ziya Firat
Dec 7, 2019·Obstetrics and Gynecology·Shravya GovindappagariKimberly D Gregory
Feb 18, 2016·Journal of Perinatal Medicine·Angela P H BurgessNisha A Lakhi
Apr 8, 2016·Obstetrics and Gynecology·Antonina I FrolovaAlison G Cahill
Jul 25, 2019·American Journal of Obstetrics and Gynecology·David B NelsonKenneth J Leveno
Jun 12, 2021·Frontiers in Pediatrics·María Luisa Mayol PérezPaloma Echevarría Pérez
Sep 14, 2021·American Journal of Obstetrics & Gynecology MFM·Mark A ClappAnjali J Kaimal
Oct 17, 2021·The Journal of Obstetrics and Gynaecology Research·Burak AkselimZeynep Toksoy Karaşin
Jul 7, 2021·Scientific Reports·Louise LundborgMia Ahlberg

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