Document Detail

Delays in the delivery room of a primary maternity unit: a retrospective analysis of obstetric outcomes.
MedLine Citation:
PMID:  23126633     Owner:  NLM     Status:  Publisher    
Abstract Objective: to compare obstetric outcomes in women undergoing vaginal delivery with or without delay in the 2(nd) and 3(rd) stage of labour (SOL). Methods: this is an observational retrospective study including 10416 full-term vaginal deliveries occurred at a primary obstetric unit. Our sample was divided according to the length of 2(nd) and 3(rd) SOL: > 2 hours versus ≤ 2 hours; and > 1 hour versus ≤ 1 hour, respectively. Obstetric outcomes were compared using univariate and multivariate analysis. Results: a prolonged 2(nd) SOL was associated with severe perineal tears [Odds Ratio (OR) = 3.53], episiotomy (OR=3.25), major post partum hemorrhage (PPH) (OR=2.35), operative delivery (OR=3.54) and asian ethnicity (OR=12.12). Likewise, a prolonged 3(rd) SOL was associated with operative deliveries (OR=10.49), labor induction (OR=3.24), non-use of oxytocin after delivery (OR=12.39), major PPH (OR=46.95), retained placenta (OR=3.57) and female fetal gender (OR=4.07). Conclusions: even at a primary care setting, where there are mostly low-risk pregnancies, a prolonged 2(nd) and 3(rd) SOL may occur and lead to poor obstetric outcomes. Our findings raise a very controversial issue about the meaning of "low obstetrics risk", given the unpredictability of any labor, and the management of complications in the delivery room of primary maternity units.
Luca Giannella; Kabala Mfuta; Deborah Pedroni; Elisabetta Delrio; Agnese Venuta; Ezio Bergamini; Lillo Bruno Cerami
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-5
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Scandiano, Italy.
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