Failure to descend, arrest of descent, and protracted descent represented 78.4% of the second stage indication category.
As a retrospective analysis, the study was limited to the available data in the delivery register which excluded such factors as booking status, antepartum haemorrhage, prelabour rupture of membranes, arrival in late second stage, indication for vacuum delivery and obstetric practices such as induction and augmentation of labour.
First and second stage indications together essentially represent a clinical category of "failure to progress" or labor dystocia.
A second multinomial logistic regression was performed for CD indication, among cesarean deliveries only, with second stage indications acting as the reference category.
In a post-hoc analysis conducted to maximize statistical efficiency by ensuring adequate cell counts in clinically meaningful categories, first and second stage indications were combined and compared with fetal distress.
To compare maternal outcomes when cesarean sections were performed in the second stage of labor to those performed in the first stage of labor by indication for the operation.
Dystocia combines the following indications: delay first stage, delay second stage, failed trial of vacuum, discoordinate uterine action and cephalopelvic disproportion (CPD).
They were also more likely to undergo CD for indications diagnosed in the first stage of labor (AOR: 3.59; 95% CI: 1.50, 8.63), as compared to indications diagnosed in the second stage of labor, after controlling for neonate size.
The indication category for CD was highest for fetal distress (40.4%), followed by indications assigned during the second stage of labor (34.4%), and then by indications assigned during the first stage of labor (25.2%).
Black women were also more likely, compared to White women, to undergo cesarean for fetal distress and indications diagnosed in the first stage as compared to the second stage of labor.
