{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:48:33Z","timestamp":1785941313754,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:00:00Z","timestamp":1626048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the duration of the second stage of labor in twin pregnancies in relation to maternal and neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study between 2014 and 2020. Eligible cases were twin pregnancies that reached the second stage. The pre\u2010defined groups were based on the total time spent in the second stage of labor; Group 1 (&lt;1\u00a0h), group 2 (1\u20132\u00a0h), and group 3 (&gt;2\u00a0h), which was considered the prolonged second stage group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 439 planned vaginal births, successful vaginal delivery of both twins was achieved in 63.8%. Prolonged second stage was observed in 25.8% (89\/345). Nulliparity (odds ratio [OR] 7.72, 95% confidence interval [CI] 4.5\u201313.4) and use of epidural analgesia (OR 5.45, 95% CI 1.2\u201324.7), were the only independent variables significantly associated with prolonged second stage. Prolonged second stage was associated with a greater risk of intrapartum cesarean delivery (32.6%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), combined delivery (10.1%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), chorioamnionitis (8.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.006) and a admission to neonatal intensive care unit of at least one of the twins (30.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prolonged second stage of labor affects maternal and fetal outcome in twin pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13787","type":"journal-article","created":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T12:44:23Z","timestamp":1623501863000},"page":"347-352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The impact of prolonged second stage in twins on perinatal outcomes"],"prefix":"10.1002","volume":"157","author":[{"given":"Ragda","family":"Zidan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niveen","family":"Saad","sequence":"additional","affiliation":[{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Siegler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naphtali","family":"Justman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Mick","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hila","family":"Ben\u2010Asher","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Beloosesky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"},{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuval","family":"Ginsberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeev","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"},{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Zipori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(54)90311-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.01.026"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000278"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.09.008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.10.926"},{"issue":"13","key":"e_1_2_8_7_1","first-page":"1","article-title":"Births: Final Data for 2018","volume":"68","author":"Martin JA","year":"2019","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2003.09.041"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214939"},{"key":"e_1_2_8_10_1","first-page":"164","article-title":"The effect of uterine overdistention on labor","volume":"23","author":"Friedman EA","year":"1964","journal-title":"I. 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