{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:25:53Z","timestamp":1762917953361,"version":"3.37.3"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T00:00:00Z","timestamp":1545350400000},"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":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,8]]},"abstract":"Background<\/jats:title>Prolonged second stage of labour is known to be associated with higher caesarean section rates. However, the association between prolonged second stage of labour (PSSL<\/jats:styled-content>) and adverse neonatal outcomes remains contradictory. The aim of this study was to assess the association between prolonged second stage of labour and obstetric and neonatal outcomes.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a retrospective cohort study of women with term, singleton pregnancies at the Mater Mother's Hospital, Brisbane. Intrapartum, maternal and neonatal outcomes were assessed and stratified according to prolonged second stage of labour.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 48\u00a0352 women, 9.7% had PSSL<\/jats:styled-content>. Women with PSSL<\/jats:styled-content> were more likely to be nulliparous and have received oxytocin for augmentation of their labour (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001), less likely to have an epidural or have undergone induction of labour (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). Women with PSSL<\/jats:styled-content> were less likely to achieve a spontaneous vaginal delivery (adjusted odds ratio (aOR)<\/jats:styled-content> 0.13, 95%CI<\/jats:styled-content> 0.12\u20130.14, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001), more likely to undergo an instrumental delivery (aOR<\/jats:styled-content> 3.93, 95%CI<\/jats:styled-content> 3.62\u20134.25, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001) or emergency caesarean section (aOR<\/jats:styled-content> 9.08, 95%CI<\/jats:styled-content> 8.00\u201310.29, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). PSSL<\/jats:styled-content> was associated with shoulder dystocia (aOR<\/jats:styled-content> 1.61, 95%CI<\/jats:styled-content> 1.42\u20131.81, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001), and postpartum haemorrhage (aOR<\/jats:styled-content> 1.37, 95%CI<\/jats:styled-content> 1.16\u20131.60, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). Univariate analysis demonstrated prolonged second stage of labour was associated with low five\u2010minute Apgar score, acidosis and neonatal intensive care admission. However, after adjusting for potential confounders only five\u2010minute Apgar scores \u22643 remained significantly increased (aOR<\/jats:styled-content> 2.36, 95% CI<\/jats:styled-content> 1.36\u20134.09, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.002).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>PSSL is associated with increased operative birth and maternal morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12935","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T16:06:37Z","timestamp":1545408397000},"page":"555-560","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prolonged second stage of labour increases maternal morbidity but not neonatal morbidity"],"prefix":"10.1111","volume":"59","author":[{"given":"Payal","family":"Matta","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1224-7046","authenticated-orcid":false,"given":"Jessica","family":"Turner","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"},{"name":"Mater Research Institute University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2225-0188","authenticated-orcid":false,"given":"Christopher","family":"Flatley","sequence":"additional","affiliation":[{"name":"Mater Research Institute University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0832-4811","authenticated-orcid":false,"given":"Sailesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"},{"name":"Mater Research Institute University of Queensland Brisbane Queensland Australia"},{"name":"Obstetrics & Gynaecology Mater Research Institute University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,21]]},"reference":[{"unstructured":"NICE.Clinical Guidelines No.55: Intrapartum Care: care of healthy women and their babies during childbirth.National Collaborating Centre for Women's and Children's Health ROCG Press 2007.","key":"e_1_2_6_2_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.1097\/AOG.0000000000001147"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1016\/j.ajog.2014.01.026"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1097\/AOG.0b013e3182704880"},{"unstructured":"WHO.World Health Organisation Statement on Caesarean Section Rates 2015.","key":"e_1_2_6_6_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_7_1","DOI":"10.1097\/01.AOG.0000444441.04111.1d"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1097\/AOG.0000000000001905"},{"unstructured":"NICE.Intrapartum care for healthy women and babies clinical guideline CG190 2017.","key":"e_1_2_6_9_1"},{"unstructured":"RANZCOG.Provision of routine intrapartum care in the absence of pregnancy complications. 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