Am J Perinatol 2012; 29(10): 807-814
DOI: 10.1055/s-0032-1316448
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Does Delayed Pushing in the Second Stage of Labor Impact Perinatal Outcomes?

Heather A. Frey
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Methodius G. Tuuli
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Sarah Cortez
2   Washington University School of Medicine in St. Louis, St. Louis, Missouri
,
Anthony O. Odibo
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Kimberly A. Roehl
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Anthony L. Shanks
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
George A. Macones
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Alison G. Cahill
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
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Weitere Informationen

Publikationsverlauf

03. Februar 2012

13. März 2012

Publikationsdatum:
06. Juli 2012 (online)

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Abstract

Objective To estimate maternal, neonatal, and labor outcomes associated with delayed pushing.

Study Design A retrospective cohort study of all consecutive women admitted to a single institution in labor at term who reached the second stage of labor. Pregnancies with multiple fetuses or major anomalies were excluded. Delayed pushing was defined as initiation of pushing ≥60 minutes after complete dilatation. Primary outcome was mode of delivery. Multivariable logistic regression was used to control for confounding.

Results Of the 5290 women who met inclusion criteria, 471 (8.9%) employed delayed pushing, and 4819 (91.1%) pushed immediately. Delayed pushing was associated with increased rates of cesarean, operative vaginal delivery, maternal fever, and lower arterial cord pH. Duration of the second stage and length of time spent pushing were significantly longer with delayed pushing.

Conclusion Delayed pushing is associated with lower rates of spontaneous vaginal delivery and increased adverse maternal and neonatal outcomes.