Document Detail


Type of attending obstetrician call schedule and changes in labor management and outcome.
MedLine Citation:
PMID:  22105267     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : To estimate whether a night-float call schedule for attending obstetricians is associated with different labor management or obstetric outcomes compared with a traditional call schedule.
METHODS: : A chart review was performed for all women admitted for labor and delivery during two 3-month periods. One period occurred immediately before a single group of generalist obstetricians changed from a traditional call schedule to a night-float call schedule, whereas the second 3-month period occurred immediately after this change. A control group of women who were managed during the same 6-month time period by a group of generalist obstetricians at the same institution who did not alter their traditional call schedule was also identified. Data on labor management and perinatal outcomes were collected.
RESULTS: : Change to a night-float call schedule was associated with a decreased use of induction of labor (30% to 16.7%, P=.02). Physicians also were more likely to use oxytocin augmentation (57.5% to 75.0%, P=.01) and less likely to manually extract the placenta (5.0% to 0%, P=.02) or perform an episiotomy (10.1% to 2.6%, P=.04). There were fewer observed third-degree and fourth-degree lacerations (10.3% to 3.3%, P=.045) and fewer neonates born with an umbilical artery pH less than 7.10 (9.3% to 2.2%, P=.03).
CONCLUSION: : A night-float call schedule was associated with both a reduction in obstetric interventions, such as labor induction and episiotomy, and improvement of particular obstetric outcomes, such as the frequency of perineal lacerations.
LEVEL OF EVIDENCE: : II.
Authors:
Emma L Barber; David L Eisenberg; William A Grobman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  118     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1371-6     Citation Subset:  AIM; IM    
Affiliation:
From the Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology and Division of Maternal Fetal Medicine, Chicago, Illinois.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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