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/OtherAbstract:
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.
Authors:
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:  -    
Affiliation:
Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Scandiano, Italy.
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