{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:05:13Z","timestamp":1784664313805,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study determines the association between fetal head station (FHS) at the diagnosis of the second stage of labor and adverse maternal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted at a single university\u2010affiliated tertiary medical center from 2011 to 2023, including singleton vertex deliveries at \u2265\u200937\u2009weeks of gestation. Participants were stratified by parity FHS at the diagnosis of the second stage: nulliparous (Group A: above the ischial spines, Group B: at the ischial spines, Group C: below the ischial spines) and multiparous (Group \u03b1: above the ischial spines, Group \u03b2: at the ischial spines, Group \u03b3: below the ischial spines). The composite maternal outcome included red blood cell transfusion, third\u2010 or fourth\u2010degree perineal tears, postpartum fever \u226538\u00b0C, intensive care unit admission, rehospitalization, or surgery within 6\u2009weeks postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 146\u2009194 deliveries, 64\u2009349 were eligible (42\u2009987 nulliparous; 21\u2009362 multiparous). Among nulliparas, 8.0%, 34.9%, and 57.2% began the second stage above, at, and below the spines, respectively; corresponding multiparous rates were 14.7%, 27.8%, and 57.5%. Nulliparas in Group A had higher transfusion rates (2.7% vs. 1.9% and 1.4%;\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001) and higher composite morbidity (5.6% vs. 4.6% and 4.1%;\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001). In multivariable regression, FHS above the ischial spines remained independently associated with increased risk for red blood cell transfusion (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1\u20131.9) and composite morbidity (OR 1.3, 95% CI 1.1\u20131.5). No association was observed among multiparous women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In nulliparous women, a higher FHS at the onset of the second stage of labor is independently associated with an increased risk of postpartum complications, irrespective of second stage duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71212","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:24:06Z","timestamp":1784661846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal outcomes according to fetal head station at diagnosis of the second stage of labor"],"prefix":"10.1002","author":[{"given":"Itamar","family":"Gilboa","sequence":"first","affiliation":[{"name":"Lis Hospital for Women's Health Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gabbai","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Lavie","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Or","family":"Rosentveig","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Baruch","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yariv","family":"Yogev","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Attali","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women's Health Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"issue":"6","key":"e_1_2_16_2_1","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1016\/0002-9378(54)90311-7","article-title":"The graphic analysis of labor","volume":"68","author":"Friedman E","year":"1954","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"e_1_2_16_3_1","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.ajog.2004.09.028","article-title":"Birth simulator: reliability of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologists classification","volume":"192","author":"Dupuis O","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_16_4_1","doi-asserted-by":"crossref","first-page":"xv","DOI":"10.1016\/B978-0-323-32108-2.00067-6","volume-title":"Obstetrics: normal and problem pregnancies","author":"Gabbe SG","year":"2017"},{"issue":"4","key":"e_1_2_16_5_1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/0002-9378(65)90511-9","article-title":"Station of the fetal presenting part. 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