title: Delays in the delivery room of a primary maternity unit: a retrospective analysis of obstetric outcomes.
abstract: OBJECTIVE
  To compare obstetric outcomes in women undergoing vaginal delivery with or without delay in the 2nd and 3rd stage of labour (SOL).
  
  
  METHODS
  This is an observational retrospective study including 10,416 full-term vaginal deliveries occurred at a primary obstetric unit. Our sample was divided according to the length of 2nd and 3rd SOL: >2 h vs. ≤2 h; and >1 h vs. ≤1 h, respectively. Obstetric outcomes were compared using univariate and multivariate analysis.
  
  
  RESULTS
  A prolonged 2nd SOL was associated with severe perineal tears (odds ratio (OR) = 3.53), episiotomy (OR = 3.25), major post-partum hemorrhage (PPH) (OR = 2.35), operative delivery (OR = 3.54), and Asian ethnicity (OR = 12.12). Likewise, a prolonged 3rd SOL was associated with operative deliveries (OR = 10.49), labor induction (OR = 3.24), non-use of oxytocin after delivery (OR = 12.39), major PPH (OR = 46.95), retained placenta (OR = 3.57) and female fetal gender (OR = 4.07).
  
  
  CONCLUSIONS
  even at a primary care setting, where there are mostly low-risk pregnancies, a prolonged 2nd and 3rd SOL may occur and lead to poor obstetric outcomes. Our findings raise a very controversial issue about the meaning of "low obstetrics risk", given the unpredictability of any labor, and the management of complications in the delivery room of primary maternity units.
authors.affiliation: Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Scandiano, Italy. lucazeta1976@libero.it
authors.forename: Luca
authors.initials: L
authors.lastname: Giannella
authors.forename: Kabala
authors.initials: K
authors.lastname: Mfuta
authors.forename: Deborah
authors.initials: D
authors.lastname: Pedroni
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Delrio
authors.forename: Agnese
authors.initials: A
authors.lastname: Venuta
authors.forename: Ezio
authors.initials: E
authors.lastname: Bergamini
authors.forename: Lillo B
authors.initials: LB
authors.lastname: Cerami
mesh_terms: D000328:Adult; D003696:Delivery Rooms / Q000706:statistics & numerical data; D004841:Episiotomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data*