Defining and Managing Normal and Abnormal Second Stage of Labor

Obstet Gynecol Clin North Am. 2017 Dec;44(4):547-566. doi: 10.1016/j.ogc.2017.08.009.

Abstract

The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 49 on Dystocia and Augmentation of Labor defines a prolonged second stage as more than 2 hours without or 3 hours with epidural analgesia in nulliparous women, and 1 hour without, or 2 hours with epidural in multiparous women. This definition diagnoses 10% to 14% of nulliparous and 3% to 3.5% of multiparous women as having a prolonged second stage. Although current labor norms remained largely based on data established by Friedman in the 1950s, modern obstetric population and practice have evolved with time.

Keywords: Cesarean; Epidural; Length of labor; Second stage of labor.

Publication types

  • Review

MeSH terms

  • Cesarean Section / methods*
  • Dystocia* / diagnosis
  • Dystocia* / physiopathology
  • Dystocia* / therapy
  • Female
  • Humans
  • Labor Stage, Second / physiology*
  • Parity / physiology
  • Patient Care Management / methods
  • Pregnancy
  • Risk Factors
  • Time Factors