TY - JOUR
T1 - Distribution of Third-Stage Length and Risk Factors for Its Prolongation
AU - Shinar, Shiri
AU - Shenhav, Michael
AU - Maslovitz, Sharon
AU - Many, Ariel
N1 - Publisher Copyright:
© 2016 Georg Thieme Verlag KG Stuttgart. New York.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Introduction The aim of our study was to demonstrate the distribution of an uncomplicated third stage and to determine the optimal time for manual intervention. Risk factors for a prolonged third stage were studied. Materials and Methods Computerized data of all vaginal deliveries at our L&D unit from 2010 to 2014 were obtained. Cases of complete and spontaneous placental separation were extracted for further analysis. Cases necessitating manual removal of the placenta due to immediate postpartum hemorrhage (PPH) were also excluded. Patient demographics, obstetrical history, course of delivery, and delivery outcome were assessed, and risk factors for a prolonged third stage were analyzed. Results There were 31,226 vaginal deliveries during the study period. Of these, 25,160 deliveries met inclusion criteria. The median third-stage length was 12 minutes. Within 30 minutes 97% of the placentas separated spontaneously. Independent risk factors for a third stage > 30 minutes included older maternal age, primiparity, history of abortions, twin gestation, and intrapartum fever. Conclusion The average time for third stage is < 15 minutes with 97% occurring by 30 minutes and 100% by 60 minutes. In the absence of PPH, it is clinically prudent to perform manual removal after 30 minutes.
AB - Introduction The aim of our study was to demonstrate the distribution of an uncomplicated third stage and to determine the optimal time for manual intervention. Risk factors for a prolonged third stage were studied. Materials and Methods Computerized data of all vaginal deliveries at our L&D unit from 2010 to 2014 were obtained. Cases of complete and spontaneous placental separation were extracted for further analysis. Cases necessitating manual removal of the placenta due to immediate postpartum hemorrhage (PPH) were also excluded. Patient demographics, obstetrical history, course of delivery, and delivery outcome were assessed, and risk factors for a prolonged third stage were analyzed. Results There were 31,226 vaginal deliveries during the study period. Of these, 25,160 deliveries met inclusion criteria. The median third-stage length was 12 minutes. Within 30 minutes 97% of the placentas separated spontaneously. Independent risk factors for a third stage > 30 minutes included older maternal age, primiparity, history of abortions, twin gestation, and intrapartum fever. Conclusion The average time for third stage is < 15 minutes with 97% occurring by 30 minutes and 100% by 60 minutes. In the absence of PPH, it is clinically prudent to perform manual removal after 30 minutes.
KW - length
KW - placenta
KW - separation
KW - stage
KW - third
UR - http://www.scopus.com/inward/record.url?scp=84965072194&partnerID=8YFLogxK
U2 - 10.1055/s-0036-1572426
DO - 10.1055/s-0036-1572426
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 27135956
AN - SCOPUS:84965072194
SN - 0735-1631
VL - 33
SP - 1023
EP - 1028
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 10
ER -