PERINATAL OUTCOME IN RELATION TO 2ND-STAGE DURATION

OBJECTIVE: The second stage of labor has been thought of as a time of particular asphyxial risk for the fetus. This perceived risk has been invoked to justify arbitrary time limits and high rates of operative v aginal delivery. The purpose of this study was to determine whether pe rinatal outcome worsened as the second stage lengthened. STUDY DESIGN: Over a 5-year period at one university teaching hospital, 6041 nullip arous women reached the second stage of labor with a live singleton ce phalic fetus with birth weight greater than or equal to 2500 gm. A ret rospective review of perinatal morbidity and mortality was performed a nd the results related to the duration of the second stage. RESULTS: T he second stage lasted >3 hours in 11% of nulliparous women and >5 hou rs in 2.7%. There were no perinatals death unrelated to anomaly. There was no significant relationship between second-stage duration and low 5-minute Apgar score, neonatal seizures, or admission to the neonatal intensive care unit. CONCLUSION: Operative intervention in the second stage is not warranted merely because some set number of hours has el apsed.