Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri 63110, USA.
Am J Perinatol. 2012 Nov;29(10):807-14. doi: 10.1055/s-0032-1316448. Epub 2012 Jul 6.
To estimate maternal, neonatal, and labor outcomes associated with delayed pushing.
A retrospective cohort study of all consecutive women admitted to a single institution in labor at term who reached the second stage of labor. Pregnancies with multiple fetuses or major anomalies were excluded. Delayed pushing was defined as initiation of pushing ≥60 minutes after complete dilatation. Primary outcome was mode of delivery. Multivariable logistic regression was used to control for confounding.
Of the 5290 women who met inclusion criteria, 471 (8.9%) employed delayed pushing, and 4819 (91.1%) pushed immediately. Delayed pushing was associated with increased rates of cesarean, operative vaginal delivery, maternal fever, and lower arterial cord pH. Duration of the second stage and length of time spent pushing were significantly longer with delayed pushing.
Delayed pushing is associated with lower rates of spontaneous vaginal delivery and increased adverse maternal and neonatal outcomes.
评估与延迟分娩相关的产妇、新生儿和分娩结局。
对在单家机构分娩且已进入足月第二产程的所有连续产妇进行的回顾性队列研究。排除多胎妊娠或主要异常的妊娠。延迟分娩定义为完全扩张后≥60 分钟开始分娩。主要结局为分娩方式。多变量逻辑回归用于控制混杂因素。
在符合纳入标准的 5290 名妇女中，471 名（8.9%）采用了延迟分娩，4819 名（91.1%）立即开始分娩。延迟分娩与剖宫产、阴道助产分娩、产妇发热和脐动脉血 pH 值降低的发生率增加有关。延迟分娩时第二产程持续时间和分娩时间明显延长。
延迟分娩与自然阴道分娩率降低以及母婴不良结局增加有关。
