Obstetric risk factors for failure to progress in the first versus the second stage of labor.
OBJECTIVE
To compare obstetric risk factors for failure of labor to progress in the first versus the second stage.


METHODS
A comparison was performed of all singleton, vertex and term deliveries with an unscarred uterus, complicated with non-progressive labor during the first and the second stages. Deliveries occurred between the years 1988 and 1999 in a tertiary university medical center.


RESULTS
Patients with non-progressive labor in the first stage (n = 1197) were significantly older, of higher birth order, and were more likely to have complications such as gestational diabetes, hypertensive disorders, premature rupture of membranes, meconium-stained amniotic fluid, hydramnios and oligohydramnios (p < 0.001 for all variables) as compared to patients with non-progressive labor in the second stage (n = 1545). In addition, pregnancies complicated with non-progressive labor in the first stage had a significantly higher rate of fetal macrosomia as compared to patients with non-progressive labor in the second stage (11.6% vs. 8.8%; p < 0.001).


CONCLUSIONS
Higher rates of fetal macrosomia and high-risk pregnancies were noted among pregnancies complicated with non-progressive labor during the first vs. the second stage. The significant increase in Cesarean deliveries during the first stage of labor among high-risk pregnancies might reflect exaggerated concern of caregivers. This concern may influence an overall conservative attitude leading to the seemingly simpler mode of direct intervention by Cesarean delivery.
Sheiner
E
E
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
Levy
A
A
Feinstein
U
U
Hershkovitz
R
R
Hallak
M
M
Mazor
M
M
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000502:physiology*; D007748:Labor Stage, Second / Q000502:physiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors