zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2019-16-1-9zdor-95Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEПРЕДИКТОРЫ ЗАТЯНУВШЕГОСЯ ВТОРОГО ПЕРИОДА РОДОВThe Predictors of Prolonged Second Stage of LaborКалачёвВ. Н.KalachevV. N.noemail@neicon.ruЗахаренковаТ. Н.ZakharenkovaT. N.noemail@neicon.ruУчреждение образования «Гомельский государственный медицинский университет»Belarus201928032019014549Copyright © Калачёв В.Н., Захаренкова Т.Н., 20192019Калачёв В.Н., Захаренкова Т.Н.Kalachev V.N., Zakharenkova T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/95

Цель: изучить предикторы затянувшегося второго периода родов. Материалы и методы. Проведено исследование родов, осложненных затянувшимся вторым периодом (n = 120). Анализ полученных данных проводился в сравнении с группой контроля, в которую вошли первородящие женщины с физиологическими родами (n = 30). Результаты. Роды, осложненные затянувшимся вторым периодом, значимо чаще начинались с индукции (р = 0,001), значительно чаще была потребность в окситоцине в родах (58 % против 36,6 % в группе контроля; р = 0,034), длительность первого периода была больше (435 (295; 520) мин против 305 (255; 470) мин; р = 0,035), а также отмечена более высокая частота заднего вида затылочного предлежания (14,8 % против 3,3 % в группе контроля; р < 0,001)). Заключение. Применение родоиндукции, необходимость использования окситоцина, а также задний вид затылочного предлежания являются предикторами затянувшегося второго периода родов.

Objective: to study the predictors of prolonged second stage of labor. Material and methods. The study of labors complicated by prolonged second stage has been performed (n = 120). The analysis of the obtained data was carried out in comparison with those of the control group which included primiparas with physiological delivery (n = 30). Results. The labors complicated by prolonged second stage more often started with induction (p = 0.001), more often there was a necessity for oxytocin in delivery (58 % vs 36.6 % in the control group; p = 0.034), the duration of the first stage was longer (435 (295; 520) min vs 305 (255; 470) min; p = 0.035), as well as a higher frequency rate of occiput posterior presentation was noted (14.8% versus 3.3% in the control group; p < 0.001)). Conclusion. The application of labor induction, the necessity for the use of oxytocin, as well as occipital posterior presentation are the predictors for prolonged second period of labor.

затянувшийся второй период родоввакуум-экстракциякесарево сечениезадний вид затылочного предлежанияprolonged second period of laborvacuum extractioncesarean sectionocciput posterior presentationReferencesACOG Practice Bulletin: No. 49. Dystocia and Augmentation of Labor. Int J Gynecol Obstet. 2003;(85);315-24; doi:10.1016/s0020-7292(04)00096-7.ACOG Practice Bulletin: No. 49. Dystocia and Augmentation of Labor. Int J Gynecol Obstet. 2003;(85);315-24; doi:10.1016/s0020-7292(04)00096-7.ACOG Practice Bulletin No. 71. American College of Obstetricians and Gynecologists Clinical management guidelines for obstetrician - gynecologists. 2006;71.ACOG Practice Bulletin No. 71. American College of Obstetricians and Gynecologists Clinical management guidelines for obstetrician - gynecologists. 2006;71.Myles T, Santolaya J. Maternal and neonatal outcomes in patients with a prolonged second stage. Obstet Gynecol. 2003;102:52-8.Myles T, Santolaya J. Maternal and neonatal outcomes in patients with a prolonged second stage. Obstet Gynecol. 2003;102:52-8.Kilpatrick SJ, Laros RK Jr. Characteristics of normal labor. Obstet Gynecol. 1989;74:85-7.Kilpatrick SJ, Laros RK Jr. Characteristics of normal labor. Obstet Gynecol. 1989;74:85-7.Cheng YW, Hopkins LM, Caughey AB. How long is too long: Does a prolonged secondstage of labor in nulliparous women affect maternal and neonatal outcomes? Defining an abnormal first stage of labor based on maternal and neonatal outcomes. Am J Obstet Gynecol. 2014;210 (6):536.e1-7.Cheng YW, Hopkins LM, Caughey AB. How long is too long: Does a prolonged secondstage of labor in nulliparous women affect maternal and neonatal outcomes? Defining an abnormal first stage of labor based on maternal and neonatal outcomes. Am J Obstet Gynecol. 2014;210 (6):536.e1-7.Пирогова НИ. Оперативное акушерство. Здоровье Украины. 2011;5:18-20.Пирогова НИ. Оперативное акушерство. Здоровье Украины. 2011;5:18-20.Davis G, Fleming T, Ford K, Mouawad MR, Ludlow J. Caesarean section at full cervical dilatation. Aust NZ J Obstet& Gynecol. 2015;55(6):565-71.Davis G, Fleming T, Ford K, Mouawad MR, Ludlow J. Caesarean section at full cervical dilatation. Aust NZ J Obstet& Gynecol. 2015;55(6):565-71.Zhu B, Grigorescu V, Le T. Labor dystocia and its association with interpregnancy interval. Am J Obstet Gynecol. 2006;195:121Zhu B, Grigorescu V, Le T. Labor dystocia and its association with interpregnancy interval. Am J Obstet Gynecol. 2006;195:121Fraser WD, Marcoux S, Krauss I, Douglas J, Goulet C, Boulvain M. Multicenter, randomized, controlled trial of delayed pushing for nulliparous women in the second stage of labor with continuous epidural anesthesia. The PEOPLE (pushing early or pushing late with epidural) study group. Am J Obstet and Gynecol.2000;182(5):1165-72.Fraser WD, Marcoux S, Krauss I, Douglas J, Goulet C, Boulvain M. Multicenter, randomized, controlled trial of delayed pushing for nulliparous women in the second stage of labor with continuous epidural anesthesia. The PEOPLE (pushing early or pushing late with epidural) study group. Am J Obstet and Gynecol.2000;182(5):1165-72.Kashanian M, Javadi F, Haghighi MM. Effect of continuous support during labor on duration of labor and rate of cesarean delivery. Int J Gynaecol Obstet. 2010;109(3):198-200.Kashanian M, Javadi F, Haghighi MM. Effect of continuous support during labor on duration of labor and rate of cesarean delivery. Int J Gynaecol Obstet. 2010;109(3):198-200.Induction of labour data. WHO Global Survey on Maternal and Perinatal Health. Geneva, World health Organization, 2010.Induction of labour data. WHO Global Survey on Maternal and Perinatal Health. Geneva, World health Organization, 2010.Ponkey S, Cohen A, Heffner LJ, Lieberman E. Persistent fetal occiput posterior position: obstetric outcomes. Obstet Gynecol. 2003;101(5):915-20.Ponkey S, Cohen A, Heffner LJ, Lieberman E. Persistent fetal occiput posterior position: obstetric outcomes. Obstet Gynecol. 2003;101(5):915-20.

The authors declare that there are no conflicts of interest present.