Length Of Labor Research Articles

Obstetric factors associated with salivary cortisol levels of healthy full-term infants immediately after birth

Purpose: To evaluate the contribution of demographic and obstetric factors to birth stress as measured by salivary cortisol levels in healthy full-term infants. Materials and Methods: Ninety-three newborn infants were born vaginally after uncomplicated pregnancies in Japan. An observational study was conducted in 2009. Saliva was collected at one minute after checking Apgar scores and determined using a commercial high-sensitivity enzyme immunoassay kit. Results: In multiple linear regression analysis, length of second-stage labor [β (95% confidence interval) = 0.041 (0.022–0.059), standardized β = 0.452] and bleeding immediately after birth [β (95% confidence interval) = 0.006 (0.001–0.010), standardized β = 0.239] were mutually and independently associated with infant salivary cortisol levels. Conclusion: The length of second-stage labor and third-stage bleeding may be causative factors or factors reflecting the cause of infant stress. This finding also provides support for the use of salivary cortisol levels in evaluating infant stress.

Using the Probability of Cesarean from a Validated Cesarean Prediction Calculator to Predict Labor Length and Morbidity.

To determine if increasing predicted risk of cesarean was associated with longer labor length and increased morbidity among women undergoing induction with an unfavorable cervix. Using a publically available database, we evaluated whether a previously validated prediction model for cesarean delivery after induction was associated with labor length, maternal morbidity (third-/fourth-degree lacerations, endometritis, blood transfusion, wound infection, venous thromboembolism, hysterectomy, intensive care unit admission, and death), and neonatal morbidity (blood transfusion, encephalopathy, intraventricular hemorrhage, severe respiratory distress syndrome, necrotizing enterocolitis, and sepsis). Full-term (≥37 weeks) singleton gestations with intact membranes and an unfavorable cervix (Bishop score ≤6 and dilation ≤2 cm) undergoing induction of labor were included. A total of 8,466 women met the inclusion criteria. Each category increase in cesarean probability (<20, 20-39.9, 40-59.9, ≥60%) was associated with an increase in labor length (9.6, 10.8, 11.7, and 11.9 hours, respectively; p < 0.001). With increasing predicted probability of cesarean there, was also a significant increase in maternal morbidity with each category (2.6, 4.7, 5.1, 6.1%; p = 0.001) and increase in neonatal morbidity (0.9, 1.5, 2, 2.2%; p = 0.002). Using a validated prediction model for cesarean delivery among women induced with an unfavorable cervix, increasing predicted probability of cesarean is associated with longer labor length and increased maternal and neonatal morbidity.

Continuous support during labour in childbirth: a Cross-Sectional study in a university teaching hospital in Shanghai, China

BackgroundFear or anxiety could result in adverse consequences on the course of labour. To date, family members are still not permitted in the delivery rooms in the majority of hospitals in China, and continuous support from hospital professional staff is also limited. This study aimed to evaluate the benefits of continuous support by family members and hospital professional staff during labour in China.MethodsIn this Cross-Sectional study, 362 primiparous pregnancies who self-requested to receive continuous or one to one support with vaginal delivery and 362 primiparous pregnant women with routine hospital maternal care were included from a university teaching hospital. Data on the length of labour, postpartum haemorrhage (PPH), use of pain relief, use of oxytocin, fetal distress, emergency caesarean section and apgar score at 1 and 5 min were retrospectively collected from hospital medical data-base and compared between the two groups.ResultsMultiple linear regressions adjusting for maternal age, BMI and birth weight, revealed the estimated length of labour for women with routine hospital maternal care was 2.03 times (95%CI 1.86 to 2.21) the duration of women with supportive care (median time, 3.05 h vs 1.5 h). In addition, Fisher’s exact test showed the emergency caesarean section rate was significantly lower in women with supportive care compared to women with routine hospital maternal care (3.3% vs 24%).ConclusionOur results suggest that continuous support from family members together with hospital professional staff should be considered as part of intrapartum care in hospitals in China.

Anemia as a risk factor of postpartum hemorrhage at dr. R. Soedjono Hospital, Selong, East Lombok

AbstractBackground and purpose: Globally, maternal mortality rate due to labor complications remains high, with postpartum hemorrhage as the most common cause. Studies on the risk factors of postpartum hemorrhage have been widely published, however, its association with maternal anemia is inconsistent. This study aims to explore anemia as a risk factor for postpartum hemorrhage.Methods: A case control study was carried out with 69 women who experienced postpartum hemorrhage as cases and 207 women who had given birth but did not experience hemorrhage as controls. Cases and controls were taken from medical records at the Dr. R. Soedjono Hospital, Selong, East Lombok District, West Nusa Tenggara. Cases were selected by systematic random sampling from 147 mothers who experienced postpartum hemorrhage during 2017. Controls were selected in the same way from 2,855 mothers who did not experience postpartum hemorrhage. Cases and controls were matched for birth weight of infants and maternal employment. Data were obtained by medical record extraction in May 2018 consisting of information on hemoglobin concentration, parity, age at pregnancy, birthing method, gestational age, birth spacing and length of labor. Data analysis was performed using logistic regression to determine the adjusted odds ratio (AOR) of anemia.Results: Characteristics of cases and controls were found to be similar in terms of infant birth weight, maternal occupation, parity, gestational age and length of delivery but statistically different by maternal age at pregnancy and birth spacing. Analysis with logistic regression showed that anemia during pregnancy with hemoglobin concentration ≤10 gr/dL was a significant risk factor for postpartum hemorrhage with AOR=16.32 (95% CI: 7.69-34.64). Delivery through caesarean section (SC) or oxytocin drip was also found to significantly reduce the risk of postpartum hemorrhage (AOR=0.03; 95%CI: 0.01-0.13).Conclusion: Anemia during pregnancy with hemoglobin concentration ≤10 gr/dL was found to be a risk factor for postpartum hemorrhage. Prevention and control of anemia in pregnant women need to be enhanced to prevent postpartum hemorrhage

Does routine amniotomy shorten the length of labor?

Eglin AFB Family Medicine Residency, Eglin AFB, FL The authors declare no conflicts of interest. The opinions and assertions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the U.S. Air Force Medical Department, the Air Force at large or the Department of Defense.

Effect of Large Compress Aroma Lavender Therapy to Intensity Scale and Old Labor of I there are Active Phase Until Second Stage in Primigravida Mother in the Region Puskesmas Pagak District Malang

The pain of labor may potentially activate the sympathetic nervous system that inhibits endogenous oxytocin secretion, which can be resolved by the method of using warm compress therapeutic aromatherapy lavender to make vasodilatation of blood vessels so that the hormone oxytocin in the body more optimal and will help the contraction of the smooth muscle of the uterus that affect the labor so that run faster.Penelitian aims to determine the influence of warm compresses of lavender aromatherapy on pain intensity and duration of labor in active phase until premiere of second stage labor on primigavida maternity.&#x0D; The research design is True Experimental Design. Population of primigravida pregnant women who have interpretation of birth November-December 2017 in Pagak Puskesmas region consisting 42 respondents. The sampling technique using Simple Randomization was obtained 38 respondents (control and treatment group). Intensity was measured using VAS (Visual Analogue Scale) scale and the length of labor was measured by partograph (minutes) .The result of calculation of Hotelling T2 (sig 0,05) 62,8392.&gt; 6,7216. H0 is rejected, meaning that there is a difference between the mean on the control and the average on the treatment. The use of warm compresses of lavender aromatherapy decreased the intensity of labor pain by 30.8%, while for the duration of labor acceleration occurred 26.4%.&#x0D; Thus warm compresses of lavender aromatherapy as one of the interventions in reducing the intensity of pain and labor acceleration in primigravid maternity, and can be applied to various health services.

Pregnancy Outcomes after Early Amniotomy among Class III Obese Gravidas Undergoing Induction of Labor.

We sought to evaluate differences in pregnancy outcomes following early amniotomy in women with class III obesity (body mass index ≥40 kg/m2) undergoing induction of labor. This is a retrospective cohort study of women with class III obesity undergoing term induction of labor from January 2007 to February 2013. Early amniotomy was defined as artificial membrane rupture at less than 4 cm cervical dilation. The primary outcome was cesarean delivery. Secondary outcomes included length of labor, a maternal morbidity composite, and a neonatal morbidity composite. A subgroup analysis examined the effect of parity. Multivariable logistic regression was used to adjust for covariates. Of 285 women meeting inclusion criteria, 107 (37.5%) underwent early amniotomy and 178 (62.5%) underwent late amniotomy. Early amniotomy was associated with cesarean delivery after multivariable adjustments (adjusted odds ratio [aOR], 2.05; 95% confidence interval [CI], 1.21-3.47). There were no significant differences in length of labor or maternal and neonatal morbidity between groups. When stratified by parity, early amniotomy was associated with increased cesarean delivery (aOR, 3.10; 95% CI, 1.47-6.58) only in nulliparous women. Early amniotomy among class III obese women, especially nulliparous women, undergoing labor induction may be associated with an increased risk of cesarean delivery.

Small Things Make a Big Difference: Birth Environments Matter

Birth environment is vitally important, not only for the comfort of the mother and her birth partners, but also to enable a woman to labour undisturbed in a positive environment which is conducive to all necessary aspects of labour and birth. This includes low lighting, warmth, privacy, as well as equipment for the woman to use to enable her to mobilise in different ways, with support. The birth environment can affect the length of labour, the use of intervention, pain experience and hormonal changes due to fear. This article describes the small changes that were implemented and resulted in dramatic positive change within the maternity unit at St George’s.

Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis.

To perform a systematic review of the relationships between prenatal exercise and maternal harms including labour/delivery outcomes. Systematic review with random effects meta-analysis and meta-regression. Online databases were searched up to 6 January 2017. Studies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise, alone ["exercise-only"] or in combination with other intervention components [e.g., dietary; "exercise + co-intervention"]) and outcome (preterm/prelabour rupture of membranes, caesarean section, instrumental delivery, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms (author defined) and diastasis recti). 113 studies (n=52 858 women) were included. 'Moderate' quality evidence from exercise-only randomised controlled trials (RCTs) indicated a 24% reduction in the odds of instrumental delivery in women who exercised compared with women who did not (20 RCTs, n=3819; OR 0.76, 95% CI 0.63 to 0.92, I 2= 0 %). The remaining outcomes were not associated with exercise. Results from meta-regression did not identify a dose-response relationship between frequency, intensity, duration or volume of exercise and labour and delivery outcomes. Prenatal exercise reduced the odds of instrumental delivery in the general obstetrical population. There was no relationship between prenatal exercise and preterm/prelabour rupture of membranes, caesarean section, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms and diastasis recti.

Effect of valethamate bromide in accelerating labor: a prospective randomized controlled trial

Objective: This prospective randomized study aimed to investigate the effect of valethamate bromide on the length of labor. Materials and Methods: A total of 200 pregnant women, who were in the 37-41 weeks of gestation, and in the active phase of labor with cervical dilatation of 6-7 cm, were included in the study. Twenty-four pregnant women that underwent cesarean section and 33 pregnant women that required oxytocin were not included in the final statistical analysis. Finally, 71 nulliparous and 72 multiparous women were randomized to four groups according to whether they received valethamate bromide or not. Groups 1 and 2 consisted of 35 nulliparous and 37 multiparous women, respectively receiving 16 mg of valethamate bromide, whereas groups 3 and 4 consisted of 36 nulliparous and 35 multiparous women, respectively, not receiving any medication, and both groups were considered as the control group. Results: There was no statistically significant difference between the groups in terms of mean maternal age and gestational age (p > 0.05). Evaluating the groups in terms of drug side effects such as maternal tachycardia, dry mouth, flushing, headache, nausea, and vomiting, no statistically significant difference was determined between the valethamate bromide groups (groups 1 and 2) and the controls (p > 0.05). There was no statistically significant difference between the study groups (group 1 vs. 3 and groups 2 vs. 4) in terms of the time from the rupture of the membranes to the second stage of labor (p > 0.05). Contrarily, the median length of the second stage of labor was 35 (5-70) minutes and 42.5 (10-70) minutes for groups 1 and 3, respectively, in the nulliparous women and the difference between the groups was considered statistically significant (p = 0.045). For the multiparous women, the median length of the second stage of labor was 12 (5-30) minutes in group 2 and 15 (5-40) minutes in group 4 and no statistically significant difference was determined between the groups (p > 0.05). The median time from the rupture of the membranes to the delivery was 100 (10-235) minutes and 87.5 (20-395) minutes in groups 1 and 3, respectively, and 50 (25-365) minutes and 50 (10-390) minutes in groups 2 and 4, respectively. No statistically significant difference was determined between the groups (p > 0.05). Conclusion: Valethamate bromide significantly shortens the second stage of labor in nulliparous women.

The Positive Association Between Duration of Skin-to-Skin Contact and Blood Glucose Level in Full-Term Infants.

The aim of this study was to evaluate the contribution of the duration of skin-to-skin contact (SSC) on blood glucose levels at 2 hours after birth in healthy full-term infants. This observational study was done at one of the baby-friendly hospitals located in Aichi, Japan in 2009. Sixty newborn infants who were born vaginally from uncomplicated pregnancies were participated. All infants were held SSC within 5 minutes. All data regarding neonatal information, blood glucose levels at 2 hours of age, and maternal information were obtained from their medical history. Multiple linear regression analysis was performed to identify the independent contribution of the duration of SSC. The mean duration of SSC was 59.6 ± 13.6 minutes (range: 11.0-97.0 minutes) and the infant blood glucose level was 53.1 ± 9.5 (range: 30.0-80.0 mg/dL) mg/dL. The duration of SSC (β [95% confidence interval] = .282 [range: 0.037-0.357], standardized β = .282, P < .017) was significantly and positively associated with infant blood glucose levels independent of gestational age, birth weight, sex, length of second-stage labor, and mode of delivery. Thus, the longer early SSC was associated with higher blood glucose level at 2 hours of age in healthy full-term infants.

Effect of epidural labor analgesia with different concentrations of ropivacaine combined with sufentanil on fever

Objective To evaluate the effect of epidural labor analgesia with different concentrations of ropivacaine combined with sufentanil on fever. Methods A total of 104 healthy parturients, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with New York Heart Association gradeⅠ or Ⅱ, with body height 150-175 cm, weighing 50-90 kg, at 37-45 weeks of gestation, scheduled for elective labor analgesia, were divided into 0.075% ropivacaine group (group R1, n=51) and 0.125% ropivacaine group (group R2, n=53) by a random number table method.Epidural labor analgesia was performed with 0.075% ropivacaine plus 0.25 μg/ml sufentanil and with 0.125% ropivacaine plus 0.25 μg/ml sufentanil in group R1 and group R2, respectively, to maintain visual analog scale score<3.Body temperature was measured before analgesia (T0), at 30 min, 1, 3 and 5 h of analgesia (T1-4), immediately after delivery and at 2 h after delivery (T5, 6). Venous blood samples were collected at T0, 3, 5 to detect the concentration of interleukin-6 (IL-6) in serum.The incidence of fever, plane of anesthesia, fluid infusion rate, consumption of sufentanil and ropivacaine, the number of increment of drugs and length of labor were recorded. Results Compared with group R1, the degree of increase in body temperature was significantly increased at T1-6, the consumption of ropivacaine and concentration of IL-6 at T3 were increased in group R2 (P 0.05). Conclusion Epidural labor analgesia with different concentrations of ropivacaine combined with sufentanil exerts no effect on fever, 0.075% ropivacaine induces less changes in body temperature of parturients than 0.125% ropivacaine, which is related to the lower concentration of IL-6. Key words: Piperidines; Sufentanil; Analgesia, epidural; Parturition; Fever

Do female elite athletes experience more complicated childbirth than non-athletes? A case–control study

ObjectivePrevious studies have suggested that female athletes might be at higher risk of experiencing complications such as caesarean sections and perineal tears during labour than non-athletes. Our aim was to...

Does an elective induction policy negatively impact on vaginal delivery rates? A 30-month review of an elective induction policy.

The rate of induction of labour varies across Health Service Executive hospital regions in Ireland averaging at 23.3 per 100 deliveries in 2005-2009. The increasing rate of elective induction of labour in Ireland calls for more studies looking into associated maternal and/or neonatal outcomes. The aim of this study is to show that an elective induction policy with management by a sole consultant obstetrician can decrease caesarean section rates as well as positively impact maternal and neonatal complications. We conducted a retrospective review of women attending a named obstetrician over a 1-year period. In total, 22 variables were collected, including basic patient demographics, mode of onset of labour, method of induction, mode of delivery, length of labour and neonatal outcomes. In total, 583 patients were identified in the study period. One hundred twenty-six (21.6%) patients presented with a spontaneous onset of labour, and 405 (69.4%) of patients had an induction of labour. Relative risk of having an emergency caesarean section, if labour is induced, is 1.42 (95% CI 0.64 to 3.14), and no statistical significance was demonstrated (p = 0.38). There was a statistically significant difference in operative vaginal delivery versus standard vaginal delivery relative risk between women ≥ 35-year-old and < 35-year-old groups, 0.47 (95% CI 0.39-0.57), p < 0.0001. Elective induction of labour is not associated with an increased risk of caesarean section or operative vaginal delivery in patients less than 35years of age. This shows that elective induction is an appropriate intervention in selected scenarios without affecting mode of delivery.

Effect of midwife-led care on birth outcomes of primiparas.

The high caesarean section rate is a prominent public health problem in China. This study aimed to determine the effects of midwife-led care during labour on birth outcomes for healthy primiparas. Randomized controlled trial. The Obstetrics Department of Fujian Provincial Maternity and Child Health Hospital. A total of 666 primiparas in labour were randomly divided into an intervention and control group (333 in each group). The intervention group received a midwife-led model of care during labour. Data from 648 cases (331 intervention group and 317 control group) were analysed. The intervention group was less likely to experience caesarean section, postpartum haemorrhage, opiate analgesia, vaginal examinations, neonatal asphyxia, and neonatal hospitalization and was more likely to experience shorter length of labour and vaginal birth than the control group (all, P<0.05). No differences were found in the number of artificial rupture of membranes and oxytocin use (P>0.05). Midwife-led care can reduce the caesarean section rate, promote normal birth, improve birth outcomes, and promote maternal and child health.

Reducing Cesarean Delivery Rates and Length of Labor by Addressing Pelvic Shape.

Reducing Cesarean Delivery Rates and Length of Labor by Addressing Pelvic Shape.

The Water@Birth Study: an exploratory study on the requirements of water for hand hygiene during labour and delivery in low-income countries

Background: Infections acquired during childbirth are one of the leading causes of maternal death; the majority of these deaths occur in low-income settings. Hand hygiene is one of the most effective ways of preventing infection but requires basic resources, such as running water, to be performed. Limited literature on water volume requirements for hand hygiene in healthcare facilities exists despite the importance of this information, particularly in resource-poor settings.Aim: To establish the volume of water required for hand hygiene during childbirth in low-income countries.Methods: Data was collected in Aberdeen Maternity Hospital (AMH) and Felege Hiwot Referral Hospital, Ethiopia (FHRH), with an average of 14 and 16 deliveries per day respectively. Primary data on hand hygiene opportunities (HHOs) during childbirth were gathered using observational methods, and secondary data gathered from register and case-note reviews. The volume of water required for each HHO (H2O/HHO) was calculated by multiplying flow rate by hand washing time. Estimates of water requirements were derived by calculating the number of HHOs during childbirth and the H2O/HHO. Water requirement estimates from each facility were compared to each other as well as to WHO recommendations. Due to skewed data, Spearman’s rho was utilised to explore the relationship between variables.Results: Eleven deliveries were observed in AMH and 20 in FHRH. The number of HHOs was largely determined by the length of labour. Stringently following WHO recommendations lead to a significantly higher number of HHOs than was performed in clinical practice at both sites. Hand washing also occurred for a much shorter time than the WHO recommendation of 40–60 seconds, with an average of 24 seconds in AMH and 25 seconds in FHRH observed. The estimated number of HHOs at sites ranged from 5 to 16 per hour per delivery and water consumption from 21 to 159.6 litres per hour per delivery. Hand hygiene was estimated to require 8937.6 litres and 4838.4 litres per day or 638.4 litres and 302.4 litres per delivery for AMH and FHRH, respectively.Conclusions: Water requirements are variable due to the nature of childbirth but are not currently met in low-income countries. In terms of performance of hand hygiene, there is a large gap between clinical and recommended practice and thus room for improvement. The volume of water required for hand hygiene has significant implications for water requirements within maternity units, particularly in resource-poor settings. Further research on water requirements is merited to improve the targeting of limited resources.

Accuracy of Clinical Estimated Fetal Weight at Term and Effect on Clinical Management [30C

INTRODUCTION: Although Obstetrics/Gynecology residents are faced with learning a wide variety of complex skills during their training, clinical estimation of fetal weight (EFW) via Leopold's maneuvers, despite the surrounding controversy of use, is a relatively simplistic skill. We wanted to determine the correlation of clinical EFW with actual birth weight (BW) in term pregnancies, and determine if this knowledge had an impact on length of labor or mode of delivery. METHODS: Retrospective chart review of singleton pregnancies between 37 and 42 weeks, admitted for labor and delivery were randomly selected, between 2013 and 2016. For 80% power, 452 women were needed to detect a difference of 10% between EFW and BW. The statistical tests used were Pearson and Spearman-Rho Correlation, Mann Whitney-U Tests and Chi Square test as appropriate. RESULTS: Of 497 women randomly selected, 9 were excluded for missing data. The mean age of was 26.8 (+/- 6.1); 33% were African American, 30% Hispanic, 27.5% White; with macrosomia rate of 7.5%. EFW had a significant, moderate positive correlation with BW (r =.43, p&lt;.001). The accuracy of EFW within 20% of actual BW was 89.2%. A significant relationship between mode of delivery and EFW noted (20.3% cesarean delivery in &lt;8 lbs group while 10.5% in &lt;8 lbs) (p=0.014). However, estimating a larger EFW did not prolong labor (367[219-580] vs 426[223-630] minutes respectively) (p=0.26). CONCLUSION: Continued practice and reinforcement of recording EFW, as part of physical examination, provides clinicians with an accurate and important tool that can aid in management of women in term labor.

Electronic Fetal Monitoring Predicts Severe Fetal Acidemia (Umbilical Cord Arterial pH [25D

INTRODUCTION: The purpose of this study was to determine how frequently intrapartum electronic fetal monitoring (EFM) was interpreted as concerning, with delivery expedited, in babies with severe acidemia (umbilical cord arterial pH &lt; 7). METHODS: A retrospective cohort study was performed on babies with umbilical cord arterial pH &lt; 7. Two groups were identified: (1) expedited delivery (either operative vaginal delivery or urgent/emergent cesarean section) and (2) non-expedited delivery (spontaneous vaginal delivery, scheduled or non-urgent cesarean section). Maternal, labor, and neonatal characteristics between the groups were compared using Chi-squared test for independence and the Fisher’s Exact Test. RESULTS: 30 babies were identified with umbilical cord arterial pH &lt; 7. 47% were delivered in expedited fashion. 53% were delivered in non-expedited fashion. Of the expedited delivery group, 79% were delivered by cesarean section and 21% by operative vaginal delivery. Of the non-expedited delivery group, 56% were delivered by cesarean section (scheduled or non-urgent). There was no statistical difference between groups in average umbilical cord arterial pH or base excess, gestational age, if labor was induced, length of labor, Pitocin usage for labor augmentation, sentinel events, 5 minute Apgar score or neonatal length of stay. CONCLUSION: Only 47% of babies with umbilical cord arterial pH of &lt; 7 delivered in expedited fashion. There was no statistical difference in maternal, labor or neonatal characteristics between the expedited and non-expedited delivery groups. Poor sensitivity of EFM in predicting intrapartum hypoxia and acidemia limits the ability to expedite delivery in the presence of fetal acidemia.

Pelvic Floor Dysfunction after Prolonged Second Stage of Labor [12A

INTRODUCTION: To evaluate whether extending the length of labor in nulliparas with prolonged second stage (PSS) affects the incidence of self-reported pelvic floor dysfunction. METHODS: Planned follow up survey to our randomized controlled trial of PSS using the Pelvic Floor Distress Inventory- 20 (PFDI-20): composed of the Pelvic Organ Prolapse Distress Inventory (POPDI-6), Colorectal-Anal Distress Inventory (CRADI-8) and Urinary Distress Inventory (UDI-6). Primary outcome: PFDI-20 summary score. Secondary outcomes: POPDI-6, CRADI-8, UDI-6 scores. Inclusion criteria: nulliparas, singleton gestation, 36.0 - 41.6 weeks, PSS. Women surveyed were previously enrolled in a study that assigned them randomly to extended labor (EL)- at least 1 additional hour in the 2nd stage, or to usual labor (UL)- expedited delivery via cesarean/operative vaginal delivery at the diagnosis of PSS. Women were surveyed at 12 - 36 months postpartum. RESULTS: Survey response rate was 43.6% (34/78). Maternal demographics were similar between groups. PFDI-20 summary score was 13.8 ± 23.3 in the EL and 13.1 ± 20.9 in the UL group (p = 0.9). POPDI-6 was 1.2 ± 2.9 in the EL group and 2.7 ± 6.4 in the UL group (p = 0.4). CRADI- 8 was 0.8 ± 2.8 in the EL group and 2.1 ± 4.0 in the UL group (p = 0.6). UDI- 6 was 11.8 ± 21.1 in the EL group and 8.3 ± 14.5 in the UL group (p = 0.6). CONCLUSION: Extending the length of labor in nulliparas with singleton gestation and PSS did not have an impact on PFDI-20 scores at 12-36 months postpartum.