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Neonatal outcomes of two‐step delivery in low‐risk pregnancy: A prospective observational study
Author(s) -
Hishikawa Kenji,
Kusaka Takeshi,
Fukuda Takanori,
Kohata Yutaka,
Inoue Hiromi
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14272
Subject(s) - medicine , asphyxia , umbilical artery , obstetrics , shoulder dystocia , pregnancy , apgar score , prospective cohort study , confidence interval , fetus , surgery , biology , genetics
Aim Extraction of the fetal body is typically performed immediately after delivery of the head in Western obstetric care. Reports justifying immediate extraction are few. Two‐step delivery entails waiting for the next uterine contraction after delivery of the head. The present study evaluates neonatal asphyxia and respiratory impairment in two‐step delivery using the head‐to‐body delivery interval. Methods This prospective observational study performed at a single birth clinic used the data of 262 low‐risk pregnant women with two‐step delivery. We measured the time interval of head‐to‐body delivery and correlation analysis and simple linear regression analysis between the head‐to‐body delivery interval and umbilical artery pH. The women were divided into two groups according to the head‐to‐body delivery interval: ≤60 or >60 s. The prevalence of neonatal asphyxia and neonatal respiratory impairment was compared between the groups. Results The mean head‐to‐body delivery interval was 88.9 ± 71.3 s. The umbilical artery pH tended to decrease with increasing head‐to‐body delivery interval; however, there was almost no correlation and the decline of pH was only 0.010 for every additional minute. Low Apgar score incidence at 5 min did not differ significantly between the groups. No cases of shoulder dystocia were reported, and tachypnea at 4 h after birth occurred in 3% of the births. Conclusions A longer head‐to‐body delivery interval is not associated with negative outcomes in two‐step delivery. We believe that two‐step delivery could have some superior outcomes compared with one‐step delivery outcomes, particularly as to improving fetal circulation and preventing shoulder dystocia.