ROLE OF FETAL MONITORING IN THE SECOND STAGE OF LABOR

Abstract

Objectives: (1) to investigate the progression of the second stage of labor, (2) to evaluation of outcome of labor base on the form of the fetal monitoring. Materials and methods: Crosse sectional describe of 379 pregnant women with vertex presentation, singleton pregnancy, at term, normal pelvis, and the fetal weight was estimated to be medium according to Vietnamese size, applying the distribution in fetal heart form according to Melchior and the distribution in stage of labor according to PEOPLE. Study period: from June 2009 to December 2009. Results: The average of the age was 27.2 ± 12 years. Gestation age (weeks) was 39.1 ± 1.2. Nulliparous women was 55.67% (211 women), and multiparous women was 44.3% (168 women). 58.4% of those whose fetus was at 0 position according to Delle’s distribution. The position of the fetus was left occiput anterior which was majority, 68%. The total duration of second stage was 88 ± 25 minutes. Fetal heart rate: Type 1 was 33.7%, type 2 was 45.5%. In the type 1, when the active phase stretch to 90 minutes, the fetus was well response. In the type 2, the second stage cannot stretch as long as these, if it lasts longer then 60minutes, not even 83.37% but just also 28.5% was at good condition, should stopped labor immediately. The mean Apgar score will < 7 at 1st minutes, 40 % and 50% in type 3 and 4 respectively. Conclusions: Left occiput anterior was 68%. Total duration of the second stage of labor was 88 ± 25 minutes. Type 0, 1, 2, 3 and 4 of fetal heart rate were 3.3%; 33.7%; 45.5%; 12.1% and 7.4% respectively. Apgar score < 7 at 1st minutes with type 0, 3 and 4 after 30 minutes for the forceful, and with type 1 after 90 minutes for that.