The management of the second stage of labor

Objective: To review obstetric practice in a single maternity hospital with respect to the assisted vaginal delivery rate. Method: A retrospective ana lysis of the hospital statistics, labor ward records, casenotes and managem ent protocols with respect to the second stage of labor was performed in a single maternity unit in the UK; the study included 43 352 women who delive red a baby,between the years of 1987 and 1997. The study looked at the rate of assisted vaginal deliveries, cesarean section, epidural in labor, and a s well as the perinatal mortality rate. Results: In the Ii-year period of t he study, 43 352 women delivered with a mean assisted vaginal delivery rate of 3.70%, cesarean section rate of 12.4% and an epidural rate of 31.5%. Co nclusion: The management of the second stage of labor in this unit results in an assisted vaginal delivery rate significantly below the national avera ge. The authors highlight the paucity of research in this important area of practice. (C) 2001 International Federation of Gynecology and Obstetrics. All rights reserved.