Frequency of Fetal Birth Asphyxia in Prolonged Second Stage of Labour

Introduction: Prolonged second stage of labour is a recognized risk factor for adverse maternal and neonatal outcomes, including fetal birth asphyxia. Timely identification and management are essential to minimize perinatal morbidity and mortality. Objective: To establish the prevalence of asphyxia in the fetus during the extended second stage of labour. Materials and Methods: This cross-sectional study was carried out in the Obstetrics and Gynecology Department, Sheikh Zayed Woman Hospital, Larkana, between January, 2025 and May 2025. One hundred women aged 18–40 years with gestational age >32 weeks and prolonged second-stage labour were randomly selected. Neonates were evaluated for birth asphyxia using Apgar scores, muscle tone, and enzyme markers (CPK, LDH). Data analysis was conducted using SPSS v. 26. Results: The prevalence of fetal birth asphyxia was 18%. It was significantly associated with unbooked status, maternal anemia, hypertension, low Bishop scores, and a second stage >4 hours. Asphyxiated neonates required NICU admission in 72.2% of cases. Conclusion: Prolonged second-stage labour increases the risk of fetal birth asphyxia. Enhanced prenatal care and timely intrapartum management can reduce adverse neonatal outcomes.