Impact of Different Delivery Modalities on Maternal and Neonatal Outcomes During Prolonged Deceleration in the Second Stage of Labor: A Retrospective Study

Sep 29, 2026

A retrospective cohort study evaluates 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. The analysis includes 114 singleton term pregnancies with vertex presentation experiencing PD between January 2022 and December 2024. Results show higher maternal morbidity in the cesarean group, while neonatal short-term outcomes remain comparable across groups. Clinical selection is individualized based on fetal station, labor progress, and operator expertise.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Objective

Methods

Results

Conclusion

Keywords

Introduction

International Journal of Women’s Health Open Access Full Text Article ORIGINAL RESEARCH Impact of Different Delivery Modalities on Maternal and Neonatal Outcomes During Prolonged Deceleration in the Second Stage of Labor: A Retrospective Study 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 Zhao 1 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; 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 [339609234@qq.com](339609234@qq.com); [553588871@qq.com](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 | | --- | | Introduction
Against the backdrop of declining global fertility rates, 1 improving the childbirth experience holds significant strategic importance for enhancing fertility intentions and addressing negative population growth. With the widespread adoption of electronic fetal monitoring (EFM), clinicians’ ability to identify fetal heart rate deceleration patterns has markedly improved. Prolonged deceleration (PD) is defined as a decrease in fetal heart rate of 15 beats per minute (bpm) or more below the baseline, lasting for at least 2 minutes but less than 10 minutes; if it persists for 10 minutes or longer, it is classified as a baseline change.2–4 The primary mechanisms involve fetal myocardial hypoxia and vagal reflexes. The | Received: 28 September 2025 Accepted: 9 December 20

FAQs

What delivery methods were compared in this study?

The study compared vacuum extraction, forceps-assisted delivery, and cesarean section for pregnancies experiencing prolonged deceleration in the second stage of labor.

What were the primary maternal and neonatal outcomes?

Maternal outcomes focused on morbidity indicators such as blood loss and hospital stay, while neonatal outcomes included measures such as umbilical artery pH and NICU admission.

How did neonatal outcomes differ across the three delivery groups?

Neonatal outcomes were comparable across all three groups, with no statistically significant differences reported.

Sep 29, 2026

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