Timing of operative vaginal delivery and associated perinatal outcomes in nulliparous women

Yvonne W. Cheng, Brian Shaffer, Katherine Bianco, Aaron Caughey

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective. To compare perinatal outcomes in nulliparous women who had operative vaginal delivery early during second stage (1-3 h) to those who delivered vaginally with a prolonged second stage (> 3 h). Methods. This is a retrospective cohort study of nulliparas with term, singleton, vaginal deliveries beyond the first hour of second stage. Women who underwent operative vaginal deliveries (OVD) during 1-3 h of the second stage were compared to women who delivered vaginally but with a second stage duration of > 3 h. Perinatal outcomes were examined using chisquare test, and potential confounders were controlled for using multivariable logistic regression analysis. Results. Nulliparas delivered vaginally beyond 3 h of second stage had lower odds of third or fourth degree perineal lacerations (aOR=0.63, 95% CI 0.51-0.77), neonatal cephalohematoma (aOR=0.48, 95% CI 0.28-0.83) and admissions to intensive care nursery (aOR=0.70, 95% CI 0.49-0.99) compared to operative vaginal deliveries during 1-3 h of second stage. Conclusion. Compared to nulliparas who had operative vaginal deliveries performed early (1-3 h) in the second stage, women who delivered later (> 3 h duration of second stage), either by spontaneous or operative vaginal delivery, had lower risk of third or fourth degree perineal lacerations without incurring risk of increased adverse neonatal outcomes.

Original languageEnglish (US)
Pages (from-to)692-697
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume24
Issue number5
DOIs
StatePublished - May 2011

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Lacerations
Nurseries
Critical Care
Cohort Studies
Retrospective Studies
Logistic Models
Regression Analysis

Keywords

  • Operative vaginal delivery
  • Perineal laceration
  • Prolonged second stage

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Timing of operative vaginal delivery and associated perinatal outcomes in nulliparous women. / Cheng, Yvonne W.; Shaffer, Brian; Bianco, Katherine; Caughey, Aaron.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 24, No. 5, 05.2011, p. 692-697.

Research output: Contribution to journalArticle

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abstract = "Objective. To compare perinatal outcomes in nulliparous women who had operative vaginal delivery early during second stage (1-3 h) to those who delivered vaginally with a prolonged second stage (> 3 h). Methods. This is a retrospective cohort study of nulliparas with term, singleton, vaginal deliveries beyond the first hour of second stage. Women who underwent operative vaginal deliveries (OVD) during 1-3 h of the second stage were compared to women who delivered vaginally but with a second stage duration of > 3 h. Perinatal outcomes were examined using chisquare test, and potential confounders were controlled for using multivariable logistic regression analysis. Results. Nulliparas delivered vaginally beyond 3 h of second stage had lower odds of third or fourth degree perineal lacerations (aOR=0.63, 95{\%} CI 0.51-0.77), neonatal cephalohematoma (aOR=0.48, 95{\%} CI 0.28-0.83) and admissions to intensive care nursery (aOR=0.70, 95{\%} CI 0.49-0.99) compared to operative vaginal deliveries during 1-3 h of second stage. Conclusion. Compared to nulliparas who had operative vaginal deliveries performed early (1-3 h) in the second stage, women who delivered later (> 3 h duration of second stage), either by spontaneous or operative vaginal delivery, had lower risk of third or fourth degree perineal lacerations without incurring risk of increased adverse neonatal outcomes.",
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N2 - Objective. To compare perinatal outcomes in nulliparous women who had operative vaginal delivery early during second stage (1-3 h) to those who delivered vaginally with a prolonged second stage (> 3 h). Methods. This is a retrospective cohort study of nulliparas with term, singleton, vaginal deliveries beyond the first hour of second stage. Women who underwent operative vaginal deliveries (OVD) during 1-3 h of the second stage were compared to women who delivered vaginally but with a second stage duration of > 3 h. Perinatal outcomes were examined using chisquare test, and potential confounders were controlled for using multivariable logistic regression analysis. Results. Nulliparas delivered vaginally beyond 3 h of second stage had lower odds of third or fourth degree perineal lacerations (aOR=0.63, 95% CI 0.51-0.77), neonatal cephalohematoma (aOR=0.48, 95% CI 0.28-0.83) and admissions to intensive care nursery (aOR=0.70, 95% CI 0.49-0.99) compared to operative vaginal deliveries during 1-3 h of second stage. Conclusion. Compared to nulliparas who had operative vaginal deliveries performed early (1-3 h) in the second stage, women who delivered later (> 3 h duration of second stage), either by spontaneous or operative vaginal delivery, had lower risk of third or fourth degree perineal lacerations without incurring risk of increased adverse neonatal outcomes.

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