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33 The most likely explanation in our view rests on spurious association: RBC transfusions are usually given to women after complicated delivery or prolonged labour, especially a prolonged third stage, with concomitant higher FMH risk.
A prolonged third stage of labour has to be considered as abnormal, requiring specific action.
In 25% of the women with a prolonged third stage (≥30 min), third stage was complicated due to retained placenta and/or severe PPH (1.8% of the low risk group).
All women with a singleton pregnancy who delivered vaginally after at least 28 weeks of gestation and had a prolonged third stage of labour (more than 30 minutes) despite active management (intramuscular administration of 5 IU oxytocin and controlled cord traction) were considered to have RP, and were eligible for inclusion in the study unless they had significant bleeding.
Risk factors for postpartum hemorrhage include a prolonged third stage of labor, multiple delivery, episiotomy, fetal macrosomia (large baby), and history of postpartum hemorrhage.
Similar(55)
Current retrospective data are mixed regarding differences in maternal and neonatal outcomes with a prolonged second stage.
In multivariate regression analysis, nulliparity and epidural analgesia were the strongest risk factors for a prolonged second stage.
Therefore, a prolonged second stage of labor has been hypothesized to be a risk factor for cervical insufficiency and spontaneous preterm birth (sPTB).
In univariate analysis, parity, oxytocin augmentation and epidural analgesia, as well as occipito-posterior presentation were significant parameters associated with a prolonged second stage of labor.
We aimed to gain insight into similarities and differences between midwives and obstetricians in the assessment of a prolonged first stage of labour and the decision to refer a woman to a clinical setting in the Netherlands.
Results: We observed that a prolonged first stage of labor resulted in increases in the numbers of nucleated cells, granulocytes, CD34+ cells, and hematopoietic progenitor cells in umbilical cord blood.
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