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Definition of Prolonged Third-Stage Labor May Be Outdated

Significantly increased postpartum hemorrhage risk with third stage of labor duration of 20 min or more

stomach measuring during pregnancy

MONDAY, April 11, 2016 (HealthDay News) -- Postpartum hemorrhage risk is significantly elevated with a third-stage labor duration of 20 minutes or more, according to research published in the May issue of Obstetrics & Gynecology.

Antonina I. Frolova, M.D., Ph.D., from the Washington University School of Medicine in St. Louis, and colleagues performed a secondary analysis of a cohort of 7,121 women who had a vaginal delivery at or beyond 37 weeks 0 days of gestation. The authors estimated the correlation between increased duration of third stage of labor and incidence of postpartum hemorrhage.

The researchers found that among women who had a vaginal delivery, the mean duration of the third stage of labor was 5.46 minutes and median duration 4 minutes. For the 705 women with a third stage above the 90th percentile (nine minutes), the risk of postpartum hemorrhage was increased compared with a third stage below the 90th percentile (13.2 versus 8.3 percent; adjusted odds ratio, 1.82). The risk for postpartum hemorrhage increased significantly beginning at 20 to 24 minutes, compared with shorter duration of the third stage (15.9 versus 8.5 percent; adjusted odds ratio, 2.38). There was no correlation for blood transfusion with third-stage duration.

"Our data show that postpartum hemorrhage risk increases significantly when the third stage of labor duration is 20 minutes or more, suggesting that the definition of a prolonged third stage of labor being 30 minutes or more may be outdated," the authors write.

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