{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T12:17:54Z","timestamp":1693397874807},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T00:00:00Z","timestamp":1588032000000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Extraction of the fetal body is typically performed immediately after delivery of the head in Western obstetric care. Reports justifying immediate extraction are few. Two\u2010step delivery entails waiting for the next uterine contraction after delivery of the head. The present study evaluates neonatal asphyxia and respiratory impairment in two\u2010step delivery using the head\u2010to\u2010body delivery interval.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study performed at a single birth clinic used the data of 262 low\u2010risk pregnant women with two\u2010step delivery. We measured the time interval of head\u2010to\u2010body delivery and correlation analysis and simple linear regression analysis between the head\u2010to\u2010body delivery interval and umbilical artery pH. The women were divided into two groups according to the head\u2010to\u2010body delivery interval: \u226460 or\u2009&gt;60\u2009s. The prevalence of neonatal asphyxia and neonatal respiratory impairment was compared between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean head\u2010to\u2010body delivery interval was 88.9\u2009\u00b1\u200971.3\u2009s. The umbilical artery pH tended to decrease with increasing head\u2010to\u2010body delivery interval; however, there was almost no correlation and the decline of pH was only 0.010 for every additional minute. Low Apgar score incidence at 5\u2009min did not differ significantly between the groups. No cases of shoulder dystocia were reported, and tachypnea at 4\u2009h after birth occurred in 3% of the births.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A longer head\u2010to\u2010body delivery interval is not associated with negative outcomes in two\u2010step delivery. We believe that two\u2010step delivery could have some superior outcomes compared with one\u2010step delivery outcomes, particularly as to improving fetal circulation and preventing shoulder dystocia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14272","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T10:55:45Z","timestamp":1588071345000},"page":"1090-1097","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neonatal outcomes of two\u2010step delivery in low\u2010risk pregnancy: A prospective observational study"],"prefix":"10.1111","volume":"46","author":[{"given":"Kenji","family":"Hishikawa","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Department Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"},{"name":"Shonan Evolutionary Obstetrics Study Group Shonan Kamakura Birth Clinic  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kusaka","sequence":"additional","affiliation":[{"name":"Shonan Evolutionary Obstetrics Study Group Shonan Kamakura Birth Clinic  Kamakura Kanagawa Japan"},{"name":"Shonan Kamakura Birth Clinic  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Kohata","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department Shonan Kamakura General Hospital  Kamakura Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127128"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200311000-00046"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00188-W"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.776534"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822467e9"},{"key":"e_1_2_7_7_1","first-page":"32","article-title":"Waiting for shoulders","volume":"42","author":"Hart G","year":"1997","journal-title":"Midwifery Today Childbirth Educ"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-6138(98)90031-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.531307"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.180522"},{"key":"e_1_2_7_11_1","first-page":"541","volume-title":"Williams Obstetrics","author":"Cunningham FG","year":"2014"},{"key":"e_1_2_7_12_1","first-page":"497","volume-title":"Williams Obstetrics","author":"Cunningham FG","year":"2014"},{"key":"e_1_2_7_13_1","first-page":"470","article-title":"Determinants of blood pressure in infants admitted to neonatal intensive care units: A prospective multicenter study. 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