Prolonged second stage of labor: Predictors of adverse maternal and perinatal outcomes in a sub‐Saharan setting

Abstract

AbstractObjectiveTo determine the predictors of adverse maternal and perinatal outcomes among parturients with prolonged second stage of labor.MethodsThis study is a cross‐sectional study of women with prolonged second stage of labor from January 1 to June 30, 2021, in four tertiary hospitals in Ethiopia. Data were collected prospectively using a structured questionnaire. Descriptive statistics were used to analyze baseline characteristics. Bivariate and multivariate logistic regression analyses were applied to determine predictors of adverse maternal and perinatal outcomes.ResultsA total of 406 women were included in the study. More than half (25/46, 54%) of the women with a prolonged second stage of 4 h or longer had vaginal delivery, which was lower than the 73% (140/190) of women who had a second stage of 2–3 h and the 63.4% (64/101) of women with a second stage duration of 3–4 h. Duration of second stage of labor was not a predictor of composite adverse maternal outcomes nor was it a predictor of adverse perinatal outcome. Operative vaginal delivery (adjusted odds ratio [aOR] 6.0, 95% confidence interval [CI] 2.41–14.9) and nulliparity (aOR 4.1, 95% CI 1.58–10.41) were predictors of adverse maternal outcome, but nulliparity (aOR 1.8, 95% CI 1.05–3.04) and duration of rupture of membranes greater than 18 h (aOR 2.4, 95% CI 1.21–4.93) were predictors of adverse perinatal outcomes.ConclusionUnder strict fetal and maternal well‐being monitoring, women with a prolonged second stage of labor can labor for an additional 2 h (up to a total of 4 h) without increasing adverse maternal and neonatal outcomes.