EP19.08: Prolonging the second stage of labour increases risks of complications

Abstract

In recent years, guidelines for prolonged second stage of labour (PSSL; 3 hrs for primiparous women with epidural and 2 hrs without; 2 hours for parous women with epidural, 1 hr without) have come under fire. Some suggest the guidelines are arbitrary and do not improve outcomes but rather lead to increased Caesarean section rates. PSSL is implicated in various maternal and neonatal complications. We investigated the role of PSSL in rates of interventional delivery modes and maternal and neonatal complications. EMR-based study of 126,000 births from 2003-2015. SSL was stratified to 15-minute strata, with 0-59 minutes as the reference category. We examined the incidence of maternal hemorrhage, meconium liquor, Apgar≤7, UA pH≤7.1, admittance to NICU, and OASIS, at each stratum. Logistic regression was used to analyse the risk of vacuum extraction or unplanned Caesarean delivery at each stratum, while controlling for persistent OP position, HC≥90th centile, BW≥90th centile, labour induction, and infant gender. Outcomes for 18,906 primiparae who received an epidural were analysed. The proportions of women and fetuses affected by interventional delivery and complications in each stratum of SSL increased from 60 minutes (figure 1); aOR's are statistically significant at 105-119 minutes. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.