Di Mascio D, Saccone G, Bellussi F, et al. - Researchers examined how delayed vs immediate pushing in the second stage of labor affects the mode of delivery and other outcomes in women with neuraxial analgesia via performing a systematic review and meta-analysis of randomized controlled trials (RCTs). Searching MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library as electronic databases, from the inception of each database to August 2019, they identified 12 RCTs, including 5,445 women with neuraxial analgesia randomized to delayed vs immediate pushing during the second stage of labor for inclusion in this meta-analysis. Outcomes revealed no impact of delayed pushing in the second stage on the mode of delivery in women with spontaneous or induced labor at term with neuraxial analgesia, although it led to reduction in the time of active pushing at the expense of a longer second stage. They identified reporting of a higher incidence of chorioamnionitis and low umbilical cord pH in correlation with this prolongation of labor. These findings do not favor routinely delaying pushing for the management of the second stage.