Duration of passive and active phases of the second stage of labour and risk of severe postpartum haemorrhage in low-risk nulliparous women

Ray, Camille Le; Fraser, William D.; Rozenberg, Patrick; Langer, B.; Subtil, D.; Goffinet, François

doi:10.1016/j.ejogrb.2011.04.035

Cited by 48 publications

(28 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To address this issue further, knowledge of the women′s experiences of childbirth before and after our study would have been of major interest and should be a focus of new studies. Long duration of labor and lower maximal dosing of oxytocin are both associated with an increased risk of postpartum hemorrhage . These findings are consistent with our observations and need further attention.…”

Section: Discussionsupporting

confidence: 91%

Judicious use of oxytocin augmentation for the management of prolonged labor

Rossen

Østborg

Lindtjørn

et al. 2015

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

Judicious use of oxytocin augmentation for the management of prolonged labor

Rossen

Østborg

Lindtjørn

et al. 2015

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

“…Another larger registry based study of risk factor for PPH [25] only found a non-significant association with labor lasting >12 hours and severe PPH ≥1500 mL (aOR = 1.9; 95% CI 0.7–5.6). Le Ray et al [18] reported a significantly longer active second stage in women who experienced severe PPH, while no increased risk of PPH was found with a prolonged active first stage. However, their study included only 69 low-risk nulliparous women, representing a subgroup of delivering women.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have reported that a prolonged second stage of labor is associated with PPH [14–16], but previous studies report conflicting results on whether the total duration of active labor increases the risk of PPH. One study looking at the first stage in women with induced labors reported an increased risk of PPH [17], while another study looking at both first and second stage in low-risk nulliparous women reported an association only with the second stage of labor [18]. The International PPH Collaborative Group [19] has recommended that prolonged labor should be among the potential risk factor for PPH investigated in future research.…”

Section: Introductionmentioning

confidence: 99%

Duration of labor and the risk of severe postpartum hemorrhage: A case-control study

et al. 2017

View full text Add to dashboard Cite

ObjectiveOur main objective was to investigate the association between duration of active labor and severe postpartum hemorrhage. We examined the effect of the total duration of active labor, the effect of each stage of active labor, and the gradient effect of duration of labor on severe postpartum hemorrhage.MethodsA case-control study was generated from a source population of all women admitted for delivery at Oslo University Hospital and Drammen Hospital in Buskerud municipality during the time period January 1, 2008 to December 31, 2011. The study population included all cases of severe postpartum hemorrhage (n = 859) and a random sample of controls (n = 1755). Severe postpartum hemorrhage was defined as postpartum blood loss ≥1500 mL or need for blood transfusion. Prolonged labor was defined as duration of active labor >12 hours according to the definition of the World Health Organization. We used logistic multivariable regression in the analysis.ResultsWe observed a significantly longer mean duration of labor in women who experienced severe postpartum hemorrhage compared to controls (5.4 versus 3.8 hours, p<0.001). Women with severe postpartum hemorrhage also had a longer duration of all stages of active labor compared to controls. The association between the duration of active labor and severe postpartum changed from a linear dose-response association to a threshold association after adjusting for augmentation with oxytocin, induction of labor, primiparity, and fever during labor. Compared to controls, women with severe postpartum hemorrhage were more likely to have a prolonged labor >12 hours (adjusted odds ratio = 2.44, 95% confidence interval: 1.69–3.53, p< 0.001).ConclusionProlonged active labor (duration >12 hours) was associated with severe postpartum hemorrhage. Increased vigilance seems required when the labor is prolonged to reduce the risk of severe postpartum hemorrhage.

show abstract

“…A reduction of interventions in uncomplicated deliveries is warranted. The risks of complications associated with long duration of active phase of labor such as postpartum hemorrhage have to be weighed against potential adverse effects of augmenting labor with oxytocin such as fetal distress and anal sphincter injuries . Childbirth satisfaction is another important outcome, and in some studies long duration is associated with lower maternal satisfaction , which might lead to cesarean section due to maternal request in later pregnancies.…”

Section: Discussionmentioning

confidence: 99%