Arrest of the Second Stage of Labor

Aka: Arrest of the Second Stage of Labor

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II. Definition

  1. Arrest of the Second Stage of Labor
    1. No descent or rotation after a fixed time interval or pushing
    2. Multiparous
      1. No epidural: 2 hours
      2. Epidural: 3 hours
    3. Nulliparous
      1. No epidural: 3 hours
      2. Epidural: 4 hours

III. Exam

  1. See Leopold's Maneuvers (Fetal Position)

IV. Complications: Prolonged second stage of labor

  1. Chorioamnionitis
  2. Neonatal Sepsis

V. Management

  1. Occiput Posterior position (or Occipitotransverse Position)
    1. See Manual Rotation in Occipitoposterior Presentation
  2. Consider assisted Vaginal Delivery

VI. References

  1. Dresang (2015) Am Fam Physician 92(3): 202-8 [PubMed]

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