| Is there an obstetric July phenomenon? | |
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MedLine Citation:
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PMID: 14672490 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To estimate whether variations in intrapartum management and complications exist with regard to the time of delivery within the academic year. METHODS: The delivery records of 7814 patients were separated by both term half year and quarter. Statistical comparisons were made using chi2 tests of association (P < .05) with respect to the academic time of the year and perineal trauma (third- or fourth-degree tear), episiotomy usage, cesarean delivery, postpartum hemorrhage, chorioamnionitis, shoulder dystocia, neonatal intensive care unit admission, 1- or 5-minute Apgar scores less than 7, and low umbilical cord pH. RESULTS: There were 4082 deliveries in the first half and 3732 in the second half of the year from April 1996 through March 1999. The first half-year overall cesarean rate was higher (15.8% versus 14.3%, P < .03). Primary cesarean rates were similar. No other differences were found by term half year. More perineal trauma was noted in the fourth quarter (first 3.3%, second 4.5%, third 3.7%, fourth 5.5%, P < .037). Episiotomy usage was higher in both the first and fourth quarters (13.0%, 11.3%, 10.6%, and 14.8%, P < .002). More cases of chorioamnionitis occurred in the fourth quarter (first 3.4%, second 3.1%, third 2.6%, fourth 4.0%, P < .038, third versus fourth quarter). Chorioamnionitis occurred more frequently in July (July 5.0% versus August-June 3.1%, P < .005). There were no other clinically significant differences. Neonatal outcomes were not affected by academic time of year. CONCLUSION: Although small differences in outcome exist with respect to the academic time of the year, the timing of these differences indicates that there is not a "July phenomenon" in obstetrics at our institution. |
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Authors:
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Thomas D Myles |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 102 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-12-15 Completed Date: 2004-01-09 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1080-4 Citation Subset: AIM; IM |
Affiliation:
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Saint Louis University School ol Medicine, Department of Obstetrics and Gynecology, St. Mary's Health Center, St. Louis, Missouri 63117, USA. mylesth@slucare1.sluh.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Chicago / epidemiology Delivery, Obstetric / methods, statistics & numerical data* Ethnic Groups / statistics & numerical data Female Hospitals, Teaching / statistics & numerical data Humans Infant, Newborn Medical Records Obstetrics / education, statistics & numerical data Physician's Practice Patterns / statistics & numerical data* Pregnancy Pregnancy Complications / epidemiology, ethnology Pregnancy Outcome / epidemiology, ethnology Retrospective Studies Seasons* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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