Parturition at term: induction, second and third stages of labor, and optimal management of life-threatening complications—hemorrhage, infection, and uterine rupture

Roberto Romero, Virginia Sabo Romero, Karim D. Kalache, Joanne Stone

Research output: Contribution to journalEditorial

Abstract

Childbirth is a defining moment in anyone's life, and it occurs 140 million times per year. Largely a physiologic process, parturition does come with risks; one mother dies every two minutes. These deaths occur mostly among healthy women, and many are considered preventable. For each death, 20 to 30 mothers experience complications that compromise their short- and long-term health. The risk of birth extends to the newborn, and, in 2020, 2.4 million neonates died, 25% in the first day of life. Hence, intrapartum care is an important priority for society. The American Journal of Obstetrics & Gynecology has devoted two special Supplements in 2023 and 2024 to the clinical aspects of labor at term. This article describes the content of the Supplements and highlights new developments in the induction of labor (a comparison of methods, definition of failed induction, new pharmacologic agents), management of the second stage, the value of intrapartum sonography, new concepts on soft tissue dystocia, optimal care during the third stage, and common complications that account for maternal death, such as infection, hemorrhage, and uterine rupture. All articles are available to subscribers and non-subscribers and have supporting video content to enhance dissemination and improve intrapartum care. Our hope is that no mother suffers because of lack of information.

Original languageEnglish
Pages (from-to)S653-S661
JournalAmerican Journal of Obstetrics and Gynecology
Volume230
Issue number3
DOIs
StatePublished - Mar 2024

Keywords

  • Apgar
  • OdonAssist™
  • cervical ripening
  • cesarean delivery
  • childbirth
  • chorioamnionitis
  • clinical management
  • complications of labor
  • diagnosis
  • failure to progress
  • fetal injury
  • forceps
  • fourth-degree laceration
  • gestation
  • hemorrhage
  • induction of labor
  • intrapartum
  • levator ani
  • midwifery
  • oxytocin
  • pelvic floor
  • pharmacology
  • postpartum
  • posttraumatic stress disorder in pregnancy (PTSD)
  • preterm labor
  • prostaglandins
  • second stage of labor
  • soft-tissue dystocia
  • sonography
  • third stage of labor
  • third-degree laceration
  • tocolysis
  • ultrasound
  • uterine rupture
  • vacuum
  • vaginal delivery
  • water birth

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