Association between Duration of Second Stage of Labour and Perinatal Outcomes among Mothers admitted in Labour at Mbarara Regional Referral Hospital, Uganda

Authors

  • Ronald Mayanja Lecturer, Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, Uganda
  • Andrew Chakura Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda
  • Musa Mubiru Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda
  • Sezalio Masembe Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda
  • Innoncent Nkonwa Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda
  • Joseph Njagi Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda
  • Wasswa Ssalongo Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda
  • Joseph Ngonzi Department of obstetrics and Gynaecology, Mbarara University of Science and Technology, P.O Box ,1410, Mbarara- Uganda

Keywords:

Perinatal, Risk, Early Labour.

Abstract

About four million babies die in the first 4 weeks of life annually. Most of the neonatal deaths occur in the first week mainly on the first day after delivery. The objective of our study was to determine the factors associated with poor perinatal   outcomes among low risk mothers admitted in labour at Mbarara Regional Referral Hospital (MRRH). This was a retrospective cohort study of mothers on the postnatal ward of MRRH. The total number of respondents was 140. The duration of second stage was ?30 minutes in 70.0% of the women.  The number of women with poor feotal outcome was 27(19.3%). The poor outcomes included, birth asphyxia, fresh still birth and early neonatal death. The odds of having a good feotal delivery outcome was inversely proportional to time, with best results registered when delivery occurred within 30minutes OR, 4.9, 95% CI (1.8-13.1), weakening towards duration of ?60 minutes with OR, 17.7, 95% CI (5.3-52.5). A second stage of labour lasting more than 60 minutes is associated with poor neonatal outcomes.

For best perinatal outcomes we recommend if the second stage exceeds 60 minutes, labour should be re-assed and action should be taken to avoid further delay. To avoid poor neonatal outcomes, a second stage of labour lasting more than 60minutes requires continuous feotal monitoring.

References

Lawn, J.E., et al., 4 million neonatal deaths: when? Where? Why? The Lancet, 2005. 365(9462): p. 891-900.
[2] Jehan, I., et al., Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. Bulletin of the World Health Organization, 2009. 87(2): p. 130-138.
[3] Allen, V.M., et al., Maternal and perinatal outcomes with increasing duration of the second stage of labor. Obstetrics & Gynecology, 2009. 113(6): p. 1248-1258.
[4] KATZ, M., et al., The effect of the duration of the second stage of labour on the acid?base state of the fetus. BJOG: An International Journal of Obstetrics & Gynaecology, 1987. 94(5): p. 425-430.
[5] Janni, W., et al., The prognostic impact of a prolonged second stage of labor on maternal and fetal outcome. Acta Obstetricia et Gynecologica Scandinavica, 2002. 81(3): p. 214-221.
[6] Cheng, Y.W., L.M. Hopkins, and A.B. Caughey, How long is too long: Does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes? American journal of obstetrics and gynecology, 2004. 191(3): p. 933-938.
[7] Cohen, W.R., Influence of the duration of second stage labor on perinatal outcome and puerperal morbidity. Obstetrics & Gynecology, 1977. 49(3): p. 266-267.
[8] Myles, T.D. and J. Santolaya, Maternal and neonatal outcomes in patients with a prolonged second stage of labor. Obstetrics & Gynecology, 2003. 102(1): p. 52-58.
[9] Fraser, W.D., et al., Multicenter, randomized, controlled trial of delayed pushing for nulliparous women in the second stage of labor with continuous epidural analgesia. American journal of obstetrics and gynecology, 2000. 182(5): p. 1165-1172.
[10] Simpson, K.R. and D.C. James, Effects of immediate versus delayed pushing during second?stage labor on fetal well?being: A randomized clinical trial. Nursing research, 2005. 54(3): p. 149-157.
[11] Nordström, L., et al., Fetal and maternal lactate increase during active second stage of labour. BJOG: An International Journal of Obstetrics & Gynaecology, 2001. 108(3): p. 263-268.
[12] Wood, C., et al., Time—an important variable in normal delivery. BJOG: An International Journal of Obstetrics & Gynaecology, 1973. 80(4): p. 295-300.
[13] Ziadeh, S. and E. Sunna, Obstetric and perinatal outcome of pregnancies with term labour and meconium-stained amniotic fluid. Archives of gynecology and obstetrics, 2000. 264(2): p. 84-87.

Downloads

Published

2016-09-22

How to Cite

Mayanja, R., Chakura, A., Mubiru, M., Masembe, S., Nkonwa, I., Njagi, J., Ssalongo, W., & Ngonzi, J. (2016). Association between Duration of Second Stage of Labour and Perinatal Outcomes among Mothers admitted in Labour at Mbarara Regional Referral Hospital, Uganda. American Scientific Research Journal for Engineering, Technology, and Sciences, 25(1), 112–130. Retrieved from https://asrjetsjournal.org/index.php/American_Scientific_Journal/article/view/2025

Issue

Vol. 25 No. 1 (2016)

Section

Articles

License

Authors who submit papers with this journal agree to the following terms.