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Prolonged second stage of labour, maternal infectious disease, urinary retention and other complications in the early postpartum period
Author(s) -
Stephansson O,
Sandström A,
Petersson G,
Wikström AK,
Cnattingius S
Publication year - 2016
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.13287
Subject(s) - medicine , caesarean section , obstetrics , odds ratio , confidence interval , pregnancy , population , urinary retention , gestational age , cephalic presentation , gestation , gynecology , surgery , genetics , environmental health , biology
Objective To study the association between duration of second stage of labour and risks of maternal complications (infection, urinary retention, haematoma or ruptured sutures) in the early postpartum period. Design Population‐based cohort study. Setting and sample We included 72 593 mothers with singleton vaginal deliveries at ≥37 weeks of gestation in cephalic presentation, using the obstetric database from the Stockholm‐Gotland region in Sweden, 2008–12. Methods Logistic regression analysis. Odds ratios ( OR s) with 95% confidence intervals (95% CI ) were calculated and adjustments were made for maternal age, body mass index, height, smoking, cohabitation, gestational age, labour induction, epidural analgesia and oxytocin augmentation. Results Rates of any complication varied by parity from 7.3% in parous women with previous caesarean section, 4.8% in primiparas and 1.7% in parous women with no previous caesarean section. Compared with a second stage <1 hour, the adjusted OR s for any complication (95% CI ) in primiparas were for 1 to <2 hours 1.28 (1.11–1.47); 2 to <3 hours 1.54 (1.32–1.79), 3 to <4 hours 1.63 (1.38–1.93) and ≥4 hours 2.08 (1.74–2.49). The corresponding adjusted OR s for parous women without previous caesarean were 2.27 (1.78–2.90), 2.97 (2.09–4.22), 3.65 (2.25–5.94) and 3.16 (1.44–6.94), respectively. The adjusted OR s for women with previous caesarean were for 1 to <2 hours 1.62 (1.13–2.32); 2 to <3 hours 1.56 (1.00–2.43), 3 to <4 hours 2.42 (1.52–3.87), and ≥4 hours 2.31 (1.25–4.24). Conclusions Risks of maternal complications in the postpartum period increase with duration of second stage of labour also after accounting for maternal, pregnancy and delivery characteristics. Special attention has to be given to parous women with previous caesarean deliveries.