Prolonged second stage labour and maternal-neonatal outcomes in northern Ethiopia: a retrospective cohort study

Abstract

Background/Aims Prolonged second stage labour is thought to be a risk factor for obstetric and perinatal complications. However, its effect on complications has been found to be inconclusive by a broad range of studies. This study aimed to investigate the relationship between adverse maternal and neonatal outcomes and prolonged second stage of labour in northern Ethiopia. Methods This retrospective cohort study included 1055 systematically selected records of women who gave birth between 1 September 2014 and 30 August 2017. Binary and multivariable logistic regression models were used to test the effect of prolonged second stage labour on maternal and neonatal outcomes. Results Adverse outcomes significantly associated with prolonged second stage labour were: operative vaginal birth (P<0.010), caesarean birth (P<0.010), puerperal sepsis (P=0.010) and third- or fourth-degree perineal tears (P=0.028), episiotomy (P=0.003), a 5-minute Apgar score <7 (P=0.030) and meconium-stained amniotic fluid (P<0.010). Conclusions Multiple adverse outcomes were significantly associated with prolonged second stage labour. Therefore, close monitoring, follow up and timely interventions are needed for women experiencing prolonged second stage labour.