Indicators for intervention during the expulsive second-stage arrest of labour.
BJOG
; 116(13): 1773-81, 2009 Dec.
Article
em En
| MEDLINE
| ID: mdl-19832827
ABSTRACT
OBJECTIVE:
To identify antepartum and intrapartum indicators of obstetric interventions during the expulsive second-stage arrest of labour.DESIGN:
Retrospective cohort study.SETTING:
The Netherlands. POPULATION A cohort of 389,086 women with singleton, cephalic, term, live-birth deliveries from 2002 to 2004 who had entered the expulsive second stage of labour. Of all these deliveries, 37,899 (9.7%) were complicated by expulsive second-stage arrest of labour. Women with a prior Caesarean section or women undergoing an elective Caesarean section were excluded.METHODS:
All deliveries in the Netherlands from 2002 to 2004 were registered in the Netherlands Perinatal Registry, which contains the linked and validated data of three databases. Uni- and multivariable logistic regression analyses were performed. MAIN OUTCOMEMEASURES:
Ante- and intrapartum indicators for interventions during expulsive second-stage arrest of labour.RESULTS:
Primiparous delivery was the most important antepartum indicator for intervention during expulsive second-stage arrest. Using multivariable analysis the following antepartum indicators were associated with intervention for expulsive second-stage arrest of primiparous labour maternal age, gestational age, diabetes, hypertension and labour induction. Prominent intrapartum indicators for primiparous deliveries were fetal head position and oxytocin augmentation.CONCLUSION:
Multiple significant antepartum and intrapartum indicators associated with intervention for expulsive second-stage arrest of labour were identified in this large retrospective study. Prominent were the associations of parity, maternal age and fetal head position with expulsive second-stage arrest. The identified factors should be further evaluated in prospective studies that aim to develop prediction models.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Distocia
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Pregnancy
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article