The management of the second stage of labor.
OBJECTIVE
To review obstetric practice in a single maternity hospital with respect to the assisted vaginal delivery rate.


METHODS
A retrospective analysis of the hospital statistics, labor ward records, casenotes and management protocols with respect to the second stage of labor was performed in a single maternity unit in the UK; the study included 43352 women who delivered a baby between the years of 1987 and 1997. The study looked at the rate of assisted vaginal deliveries, cesarean section, epidural in labor, and as well as the perinatal mortality rate.


RESULTS
In the 11-year period of the study, 43352 women delivered with a mean assisted vaginal delivery rate of 3.70%, cesarean section rate of 12.4% and an epidural rate of 31.5%.


CONCLUSIONS
The management of the second stage of labor in this unit results in an assisted vaginal delivery rate significantly below the national average. The authors highlight the paucity of research in this important area of practice.
O'Connell
M P
MP
National Maternity Hospital, Dublin, Ireland.
Tetsis
A V
AV
Lindow
S W
SW
D000767:Anesthesia, Epidural / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D008499:Medical Records; D009772:Obstetrical Forceps / Q000706:statistics & numerical data; D011247:Pregnancy; D012189:Retrospective Studies; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data