title: Non-progressive labor in the second stage leading to vacuum extraction is a risk factor for recurrent non-progressive labor.
abstract: OBJECTIVE
  To address risk factors and perinatal outcomes after vacuum-assisted delivery (VAD) due to non-progressive labor (NPL) 2nd stage, and to assess its impact on the subsequent delivery.
  
  
  METHODS
  A retrospective, population-based cohort study was conducted in a tertiary medical center. Maternal characteristics, and maternal and neonatal outcomes of singleton pregnancies that resulted in VAD due to NPL 2nd stage were compared to those that resulted in VAD due to other indications. Multiple logistic regression models were constructed.
  
  
  RESULTS
  Out of 202,462 singleton deliveries, 3.4% were delivered using VAD. Of these, 1928 VAD due to NPL 2nd stage and 4985 VAD due to other indications were identified. Independent risk factors for VAD due to NPL 2nd stage were identified: advanced gestational age, pre-eclampsia, and labor induction. VAD due to NPL 2nd stage in the index pregnancy was noted as an independent risk factor for NPL 1st stage and NPL 2nd stage during the subsequent pregnancy.
  
  
  CONCLUSIONS
  VAD due to NPL 2nd stage results in adverse perinatal outcome in the index and subsequent pregnancies. VAD due to NPL 2nd stage in the index pregnancy is an independent risk factor for NPL 1st stage and NPL 2nd stage during the subsequent pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Harlev
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Fatool
authors.affiliation: Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel. sheiner@bgu.ac.il.
authors.forename: Eyal
authors.identifier: http://orcid.org/0000-0002-0454-6874
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects; D007743:Labor, Obstetric; D016015:Logistic Models; D011225:Pre-Eclampsia; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D014620:Vacuum Extraction, Obstetrical
keywords: Failure to progress; Non-progressive labor; Perinatal outcome; Subsequent pregnancy; Vacuum-assisted delivery