{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T01:49:34Z","timestamp":1767836974047,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T00:00:00Z","timestamp":1499904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To observe the incidence of, indications for, and complications associated with second\u2010stage cesarean delivery in 10\u2010year intervals over 30\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present analysis of prospectively collected data compared cesarean deliveries during 1976, 1986, 1996, and 2006 at John Radcliffe Hospital in Oxford, <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> (n=3222). Pregnancy, delivery, and neonatal details were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of deliveries by cesarean in the second stage of labor increased from 0.5% (22\/4464) in 1976 to 2.1% (124\/5998) in 2006 (<jats:italic>P<\/jats:italic>&lt;0.001). The proportion of cesarean deliveries during the second stage because of failed instrumental delivery also increased over the study period from 59.1% (13\/22) in 1976 to 71.0% (88\/124) in 2006. Compared with cesareans at other stages, uterine trauma (<jats:italic>P<\/jats:italic>&lt;0.001), blood loss greater than 1000\u00a0mL (<jats:italic>P<\/jats:italic>=0.002), and blood transfusion (<jats:italic>P<\/jats:italic>=0.001) were more frequent in second\u2010stage cesarean delivery. Neonates delivered by second\u2010stage cesarean had lower Apgar scores (<jats:italic>P<\/jats:italic>&lt;0.001 for 1\u2010min and 5\u2010min scores) and cord arterial <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> values (<jats:italic>P<\/jats:italic>&lt;0.001) than did those delivered by cesarean earlier in labor. A trend towards an increase in neonatal trauma with second\u2010stage cesarean compared with cesarean delivery before labor or during the first stage did not reach statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The proportion of deliveries by cesarean in the second stage of labor increased; these deliveries were associated with greater maternal and neonatal morbidity, but were not influenced by the indication for cesarean.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12236","type":"journal-article","created":{"date-parts":[[2017,6,11]],"date-time":"2017-06-11T09:02:46Z","timestamp":1497171766000},"page":"340-346","source":"Crossref","is-referenced-by-count":11,"title":["A cross\u2010sectional study exploring the incidence of and indications for second\u2010stage cesarean delivery over three decades"],"prefix":"10.1002","volume":"138","author":[{"given":"Greg A.","family":"Pearson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Torbay and South Devon NHS Foundation Trust  Torquay, Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian Z.","family":"MacKenzie","sequence":"additional","affiliation":[{"name":"Nuffield Department of Obstetrics and Gynaecology University of Oxford John\u00a0Radcliffe Hospital  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12386"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38971.466979.DE"},{"key":"e_1_2_7_4_1","volume-title":"The European Working Time Directive and Maternity Services. 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