Frequency of Fetal Birth Asphyxia in Prolonged Second Stage of Labour
DOI:
https://doi.org/10.70749/ijbr.v3i7.2142Keywords:
Prolonged labour, fetal birth asphyxia, Apgar score, NICU admission, second stage of labourAbstract
Introduction: Prolonged second stage of labour is a recognized risk factor for adverse maternal and neonatal outcomes, including fetal birth asphyxia. Timely identification and management are essential to minimize perinatal morbidity and mortality. Objective: To establish the prevalence of asphyxia in the fetus during the extended second stage of labour. Materials and Methods: This cross-sectional study was carried out in the Obstetrics and Gynecology Department, Sheikh Zayed Woman Hospital, Larkana, between January, 2025 and May 2025. One hundred women aged 18–40 years with gestational age >32 weeks and prolonged second-stage labour were randomly selected. Neonates were evaluated for birth asphyxia using Apgar scores, muscle tone, and enzyme markers (CPK, LDH). Data analysis was conducted using SPSS v. 26. Results: The prevalence of fetal birth asphyxia was 18%. It was significantly associated with unbooked status, maternal anemia, hypertension, low Bishop scores, and a second stage >4 hours. Asphyxiated neonates required NICU admission in 72.2% of cases. Conclusion: Prolonged second-stage labour increases the risk of fetal birth asphyxia. Enhanced prenatal care and timely intrapartum management can reduce adverse neonatal outcomes.
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1. Young C, Bhattacharya S, Woolner A, Ingram A, Smith N, Raja EA, Black M. Maternal and perinatal outcomes of prolonged second stage of labour: a historical cohort study of over 51,000 women. BMC Pregnancy and Childbirth. 2023 Jun 22;23(1):467.
https://doi.org/10.1186/s12884-023-05733-z
2. Ahmed R, Mosa H, Sultan M, Helill SE, Assefa B, Abdu M, Ahmed U, Abose S, Nuramo A, Alemu A, Demelash M. Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: a systematic review and meta-analysis. PLoS One. 2021 Aug 5;16(8):e0255488.
https://doi.org/10.1371/journal.pone.0255488
3. Blanc-Petitjean P, Saumier S, Meunier G, Sibiude J, Mandelbrot L. Prolongation of active second stage of labor: associated factors and perinatal outcomes. Journal of Gynecology Obstetrics and Human Reproduction. 2021 Dec 1;50(10):102205.
https://doi.org/10.1016/j.jogoh.2021.102205
4. Ayebare E, Hanson C, Nankunda J, Hjelmstedt A, Nantanda R, Jonas W, Tumwine JK, Ndeezi G. Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study. BMC Pregnancy and Childbirth. 2022 Oct 12;22(1):767.
https://doi.org/10.1186/s12884-022-05095-y
5. Niemczyk NA, Ren D, Stapleton SR. Associations between prolonged second stage of labor and maternal and neonatal outcomes in freestanding birth centers: a retrospective analysis. BMC Pregnancy and Childbirth. 2022 Feb 4;22(1):99.
https://doi.org/10.1186/s12884-022-04421-8
6. Lundborg L, Åberg K, Sandström A, Liu X, Tilden E, Stephansson O, Ahlberg M. Association between first and second stage of labour duration and mode of delivery: a population-based cohort study. Paediatric and Perinatal Epidemiology. 2022 May;36(3):358-67.
https://doi.org/10.1111/ppe.12848
7. Tunç Ş, Oğlak SC, Gedik Özköse Z, Ölmez F. The evaluation of the antepartum and intrapartum risk factors in predicting the risk of birth asphyxia. Journal of Obstetrics and Gynaecology Research. 2022 Jun;48(6):1370-8.
https://doi.org/10.1111/jog.15214
8. Kumsa H, Mullu G, Dimtsu B, Gebre G, Reda MA, Yimer N. Prolonged second stage labour and maternal-neonatal outcomes in northern Ethiopia: a retrospective cohort study. African Journal of Midwifery and Women's Health. 2023 Apr 2;17(2):1-9.
https://doi.org/10.12968/ajmw.2022.0031
9. Bibi S, Gilani SY, Bibi S. Risk Factors for Birth Asphyxia–an Experience from A Tertiary Care Setting. In Medical Forum Monthly 2022 (Vol. 33, No. 8).
10. Sunny AK, Paudel P, Tiwari J, Bagale BB, Kukka A, Hong Z, Ewald U, Berkelhamer S, Ashish KC. A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal. BMC Pediatrics. 2021 Dec;21:1-8.
https://doi.org/10.1186/s12887-021-02858-y
11. Molla M, Mekonnen A, Godie Y, Guadie Y, Birhanu D. Magnitude of Birth Asphyxia and Associated Factors among Newborns Admitted in Neonatal Intensive Care Unit at Government Hospitals in Addis Ababa, Ethiopia, 2021: Multicenter Cross-Sectional Study. Neonat Pediatr Med. 2022;8(246):2.
12. Ikechebelu JI, Eleje GU, Onubogu CU, Ojiegbe NO, Ekwochi U, Ezebialu IU, Ezenkwele EP, Nzeribe EA, Umeh UA, Obumneme-Anyim I, Nwokeji-Onwe LN. Incidence, predictors and immediate neonatal outcomes of birth asphyxia in Nigeria. BJOG: An International Journal of Obstetrics & Gynaecology. 2024 Aug;131:88-100.
https://doi.org/10.1111/1471-0528.17816
13. Bayih WA, Tezera TG, Alemu AY, Belay DM, Hailemeskel HS, Ayalew MY. Prevalence and determinants of asphyxia neonatorum among live births at Debre Tabor General Hospital, North Central Ethiopia: a cross-sectional study. African Health Sciences. 2021 Apr 16;21(1):385-96.
https://doi.org/10.4314/ahs.v21i1.49
14. Ngongo NN, Sichamba P, Chishala N, Chibeka MD, Chimba M, Kacha S, Simutowe K, Mulambo P, Riwo EO, Baines SM, Kurehwatira KR. Prevalence and risk factors of birth asphyxia at Livingstone University Teaching Hospital. medRxiv. 2025:2025-05.
https://doi.org/10.1101/2025.05.21.25328124
15. Sapir A, Friedrich L, Gat R, Erez O. Cesarean section in the second stage of labor is associated with early-term and late preterm birth in subsequent pregnancies. The Journal of Maternal-Fetal & Neonatal Medicine. 2023 Dec 31;36(1):2175658.
https://doi.org/10.1080/14767058.2023.2175658
16. Li Y, Zhang L, Huang L, Liang Y, Chen J, Bi S, Deng W, Lin L, Wang X, Ren L, Zeng S. Association between the second-stage duration of labor and perinatal outcomes in women with a prior cesarean delivery. BMC Pregnancy and Childbirth. 2022 Jul 5;22(1):543.
https://doi.org/10.1186/s12884-022-04871-0
17. Awoyesuku PA, John DH, Josiah AE, Sapira-Ordu L. Maternal, obstetric, and foetal risk factors for perinatal asphyxia: Prevalence and outcome at a tertiary hospital in Port Harcourt, Nigeria. Nigerian Journal of Medicine. 2022 Jul 28;31(3):285-92.
https://doi.org/10.4103/njm.njm_197_21
18. Abose S, Nuramo A, Brehane M, Lemma L, Ahemed R, Gebrehiwot H. The prevalence and associated factors of birth asphyxia among neonates delivered in Public Hospitals, Northern Ethiopia. African Health Sciences. 2022 Aug 1;22(2):518-25.
https://doi.org/10.4314/ahs.v22i2.60
19. Gimovsky AC, Pham A, Ahmadzia HK, Sparks AD, Petersen SM. Risks associated with cesarean delivery during prolonged second stage of labor. American Journal of Obstetrics & Gynecology MFM. 2021 Jan 1;3(1):100276.
https://doi.org/10.1016/j.ajogmf.2020.100276
20. Torabifar N, Dezfuli SA, Kassani A. The Relationship Duration of the Second Stage of Labor and Neonatal Apgar Score in the Primipara Women. Mathews Journal of Gynecology & Obstetrics. 2024 Mar 19;8(1):1
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