title: Obstetric risk factors for failure to progress in the first versus the second stage of labor.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Sheiner
authors.forename: A
authors.initials: A
authors.lastname: Levy
authors.forename: U
authors.initials: U
authors.lastname: Feinstein
authors.forename: R
authors.initials: R
authors.lastname: Hershkovitz
authors.forename: M
authors.initials: M
authors.lastname: Hallak
authors.forename: M
authors.initials: M
authors.lastname: Mazor
mesh_terms: 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