Materno-Foetal Morbidity in the Second Stage of Labour: A Cohort Study in Primiparous Women in Yaounde

Introduction: Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. Methods: It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software. Results: Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1 - 2 hours (44.9% versus 22.7%;p < 0.001) and >2 hours (42.9% versus 22.7%;p = 0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1 - 2 hours (versus 6.3%;p < 0.001) and 19.0% for SSLs > 2 hours (versus 6.3%;p = 0.007). Conclusion: Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.