Influence of the duration of second stage labor on perinatal outcome and puerperal morbidity.

Obstetric data from 4403 nulliparas were analyzed in order to determine whether the duration of the second stage of labor influences perinatal outcome or maternal puerperal morbidity. No significant increase in the frequency of perinatal mortality, neonatal mortality, or low 5-minute Apgar scores was noted with long second stages. An increase in the incidence of low 1-minute Apgar scores was observed only in those infants who were not monitored. An increase in puerperal hemorrhage after more than 3 hours of second stage labor was attributable to those patients delivered by midforceps operations. It appears that it is unwarranted to terminate labor simply because an arbitrary period of time has elapsed in the second stage.