Document Detail

Hospital practice versus evidence-based obstetrics: categorizing practices for normal birth in an Egyptian teaching hospital.
MedLine Citation:
PMID:  16336369     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known of common normal labor hospital practices in Egypt or of their relationship to evidence-based obstetrics. This study documented facility-based practices for normal labor and delivery in Egypt for the first time by categorizing 44 practices observed in a busy obstetric teaching hospital according to the World Health Organization (WHO) Technical Working Group on Normal Birth classification of normal birth practices.
METHODS: A multidisciplinary approach combined directly observing practices that were applied to individual laboring women and their newborns, observing ward activities, interviews, and focus groups. One hundred seventy-five normal births were observed in their entirety, over 28 days and nights, by medically trained observers using an observation checklist that documented 537 variables for each woman. Mothers were interviewed postpartum, and findings were shared with practitioners for their feedback. Observed practices were categorized according the 1999 WHO classification of 59 practices for normal birth, depending on their usefulness, effectiveness, or harmfulness.
RESULTS: There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately, and practices of unproved benefit were also documented, some of which are potentially harmful to childbearing mothers and their babies.
CONCLUSIONS: Hospital practices for normal labor were largely not in accordance with the WHO evidence-based classification of practices for normal birth. The findings are worrying, given the increasing proportion of hospital-based births in Egypt and the country's improved but relatively high maternal and neonatal mortality rates. Obstacles to following evidence-based protocols for normal labor require examination.
Karima Khalil; Amr Elnoury; Mohamed Cherine; Hania Sholkamy; Nevine Hassanein; Lamia Mohsen; Miral Breebaart; Abdel Aziz Shoubary
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Birth (Berkeley, Calif.)     Volume:  32     ISSN:  0730-7659     ISO Abbreviation:  Birth     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-12     Completed Date:  2006-02-23     Revised Date:  2013-03-08    
Medline Journal Info:
Nlm Unique ID:  8302042     Medline TA:  Birth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-90     Citation Subset:  IM    
Population Council, West Asia & North Africa Regional Office.
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MeSH Terms
Data Collection / methods
Delivery, Obstetric / standards*
Evidence-Based Medicine*
Guideline Adherence / statistics & numerical data*
Hospitals, Teaching
Physician's Practice Patterns / statistics & numerical data*
Practice Guidelines as Topic
World Health Organization
Grant Support
074986//Wellcome Trust; //Wellcome Trust
Erratum In:
Birth. 2006 Mar;33(1):82

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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