Delayed Second Stage of Labor
Written by Dr.M.D.Mazumdar, MD
The second stage of labour is said to be delayed if there is no delivery of the baby even after 2 hours of full dilation of the cervix in a first pregnancy and 1 hour in a woman with previous pregnancies.
There are various causes of delay in the second stage of labor, all of which are closely linked to each other.
For example, the second stage can get delayed due to lack of proper contraction of the uterus which again can be due to either a malposition of the fetus or due to cephalopelvic disproportion (CPD) .
Causes of Delayed Second Stage of Labor
The second stage of labour may be delayed due to:
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Assessment of Delayed Second Stage of Labor
Once a diagnosis of delay in the second stage is made, the woman should be assessed for:
Management / Treatment of Delayed Second Stage of Labor
If the head is high up:
- Since the cervix is fully dilated in the second stage of labour, but the presenting part of the foetus is very high up, an attempt is made to increase labour pains with the help of medicines like oxytocin.
If, after 1 hour, there is no progress and the presenting part is still high up, caesarian section is done.
- If presenting part is high up and there are signs of foetal distress, an immediate caesarian section is done.
- If the greatest diameter of the head is below the narrowest part of the pelvic canal (at the level of the ischial spine), then labour pains are augmented by medicines like oxytocin and a normal delivery expected.
- If there are signs of fetal distress, and the head is low down, Forceps Delivery or Vacuum Extraction of the foetus is done.
- Forceps Delivery or Vacuum Extraction of the foetus is also done where there is maternal distress due to prolonged labour.
- The Three stages of Normal Labor
- What to do Immediately after Childbirth.
- The Pregnancy Test .
- Problems in the Postpartum Period.
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