Document Detail

Is there an obstetric July phenomenon?
MedLine Citation:
PMID:  14672490     Owner:  NLM     Status:  MEDLINE    
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.
Thomas D Myles
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-15     Completed Date:  2004-01-09     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1080-4     Citation Subset:  AIM; IM    
Saint Louis University School ol Medicine, Department of Obstetrics and Gynecology, St. Mary's Health Center, St. Louis, Missouri 63117, USA.
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MeSH Terms
Chicago / epidemiology
Delivery, Obstetric / methods,  statistics & numerical data*
Ethnic Groups / statistics & numerical data
Hospitals, Teaching / statistics & numerical data
Infant, Newborn
Medical Records
Obstetrics / education,  statistics & numerical data
Physician's Practice Patterns / statistics & numerical data*
Pregnancy Complications / epidemiology,  ethnology
Pregnancy Outcome / epidemiology,  ethnology
Retrospective Studies

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

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