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Research Article

Delays in the delivery room of a primary maternity unit: a retrospective analysis of obstetric outcomes

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Pages 593-597 | Received 20 Apr 2012, Accepted 23 Oct 2012, Published online: 29 Nov 2012
 

Abstract

Objective: To compare obstetric outcomes in women undergoing vaginal delivery with or without delay in the 2nd and 3rd stage of labour (SOL). Methods: This is an observational retrospective study including 10,416 full-term vaginal deliveries occurred at a primary obstetric unit. Our sample was divided according to the length of 2nd and 3rd SOL: >2 h vs. ≤2 h; and >1 h vs. ≤1 h, respectively. Obstetric outcomes were compared using univariate and multivariate analysis. Results: A prolonged 2nd SOL was associated with severe perineal tears (odds ratio (OR) = 3.53), episiotomy (OR = 3.25), major post-partum hemorrhage (PPH) (OR = 2.35), operative delivery (OR = 3.54), and Asian ethnicity (OR = 12.12). Likewise, a prolonged 3rd SOL was associated with operative deliveries (OR = 10.49), labor induction (OR = 3.24), non-use of oxytocin after delivery (OR = 12.39), major PPH (OR = 46.95), retained placenta (OR = 3.57) and female fetal gender (OR = 4.07). Conclusions: even at a primary care setting, where there are mostly low-risk pregnancies, a prolonged 2nd and 3rd SOL may occur and lead to poor obstetric outcomes. Our findings raise a very controversial issue about the meaning of “low obstetrics risk”, given the unpredictability of any labor, and the management of complications in the delivery room of primary maternity units.

Acknowledgments

We thank Dr. SSA Annamaria Venuta for advice in English-language editing, and Dr. SSA Lucia Mangone for advice in statistical analyses.

Declaration of Interest: The authors report no declarations of interest.

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