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已发表论文
不同分娩方式对第二产程延长减速时母婴结局的影响：一项回顾性研究
Authors Jian WQ, Yang F, Jian J, He MP, Yuan CL, Huang JC, Wei QF, Zhao KS
Received 28 September 2025
Accepted for publication 9 December 2025
Published 31 December 2025 Volume 2025:17 Pages 5839—5850
DOI https://doi.org/10.2147/IJWH.S570950
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Vinay Kumar
Wen Qian Jian,1,* Feng Yang,2,* Jun Jian,3 Mei Ping He,1 Chun Lan Yuan,1 Jian Chun Huang,1 Qing Fang Wei,1 Kai Sun Zhao1
1Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China; 2Department of Gynaecology, The Third Affiliated Hospital of Guangxi Medical University, The second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China; 3Department of Anesthesiology, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Kai Sun Zhao, Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, No. 13, Dancun Road, Jiangnan District, Nanning City, Guangxi Zhuang Autonomous Region, People’s Republic of China, Tel +86 0771 4808241, Email 339609234@qq.com Qing Fang Wei, Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, No. 13, Dancun Road, Jiangnan District, Nanning City, Guangxi Zhuang Autonomous Region, People’s Republic of China, Tel +86 0771 4808241, Email 553588871@qq.com
Objective: To investigate the effects of three delivery methods—vacuum extraction, forceps-assisted delivery, and cesarean section—on maternal and neonatal outcomes during prolonged deceleration (PD) in the second stage of labor, providing evidence-based support for clinical decision-making.
Methods: This retrospective cohort study analyzed 114 singleton, term pregnancies with vertex presentation experiencing PD in the second stage of labor between January 2022 and December 2024. Participants were categorized by delivery method: vacuum extraction (n=62), forceps delivery (n=30), and cesarean section (n=22). Primary outcomes included maternal morbidity indicators (eg, blood loss, hospital stay) and neonatal outcomes (eg, umbilical artery pH, NICU admission).
Results: The cesarean section group had a higher fetal station, a longer deceleration-to-delivery interval, and significantly increased maternal morbidity, including longer postpartum hospital stay, higher costs, extended antibiotic use and catheterization, and greater blood loss compared to instrumental delivery groups (all P < 0.05). The forceps group had a higher incidence of wound erythema than the cesarean group (P < 0.05). Critically, neonatal outcomes were comparable across all three groups (P > 0.05).
Conclusion: During PD in the second stage of labor, both operative vaginal delivery and cesarean section present a trade-off between maternal morbidity and procedural expediency. The choice of delivery method should be individualized, based on a rapid assessment of fetal station, labor progress, and operator expertise, as neonatal short-term outcomes were similar regardless of the mode of delivery.
Keywords: second stage of labor, prolonged deceleration, cesarean section, vacuum extraction, forceps delivery
1Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China; 2Department of Gynaecology, The Third Affiliated Hospital of Guangxi Medical University, The second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China; 3Department of Anesthesiology, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Kai Sun Zhao, Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, No. 13, Dancun Road, Jiangnan District, Nanning City, Guangxi Zhuang Autonomous Region, People’s Republic of China, Tel +86 0771 4808241, Email 339609234@qq.com Qing Fang Wei, Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, No. 13, Dancun Road, Jiangnan District, Nanning City, Guangxi Zhuang Autonomous Region, People’s Republic of China, Tel +86 0771 4808241, Email 553588871@qq.com
Objective: To investigate the effects of three delivery methods—vacuum extraction, forceps-assisted delivery, and cesarean section—on maternal and neonatal outcomes during prolonged deceleration (PD) in the second stage of labor, providing evidence-based support for clinical decision-making.
Methods: This retrospective cohort study analyzed 114 singleton, term pregnancies with vertex presentation experiencing PD in the second stage of labor between January 2022 and December 2024. Participants were categorized by delivery method: vacuum extraction (n=62), forceps delivery (n=30), and cesarean section (n=22). Primary outcomes included maternal morbidity indicators (eg, blood loss, hospital stay) and neonatal outcomes (eg, umbilical artery pH, NICU admission).
Results: The cesarean section group had a higher fetal station, a longer deceleration-to-delivery interval, and significantly increased maternal morbidity, including longer postpartum hospital stay, higher costs, extended antibiotic use and catheterization, and greater blood loss compared to instrumental delivery groups (all P < 0.05). The forceps group had a higher incidence of wound erythema than the cesarean group (P < 0.05). Critically, neonatal outcomes were comparable across all three groups (P > 0.05).
Conclusion: During PD in the second stage of labor, both operative vaginal delivery and cesarean section present a trade-off between maternal morbidity and procedural expediency. The choice of delivery method should be individualized, based on a rapid assessment of fetal station, labor progress, and operator expertise, as neonatal short-term outcomes were similar regardless of the mode of delivery.
Keywords: second stage of labor, prolonged deceleration, cesarean section, vacuum extraction, forceps delivery