Display Settings:

Format

Send to:

Choose Destination
Acta Obstet Gynecol Scand. 2014 Feb;93(2):189-93. doi: 10.1111/aogs.12307. Epub 2013 Dec 19.

Maternal and neonatal morbidity during off peak hours in a busy obstetric unit. Are deliveries after midnight more complicated?

Author information

  • 1National Maternity Hospital, Dublin, Ireland.

Abstract

OBJECTIVE:

We sought to compare maternal and neonatal outcomes in deliveries occurring overnight with those in daylight hours.

DESIGN:

Prospective observational study.

SETTING:

Large national tertiary referral center.

POPULATION:

All singleton laboring nulliparous parturients delivering infants >500 g over a 2-year period, 1 January 2008 to 31 December 2009.

METHODS:

Details of intrapartum characteristics and neonatal outcomes of deliveries occurring between midnight and 08.00 h were compared with deliveries occurring outside of these hours.

MAIN OUTCOME MEASURES:

Maternal and neonatal morbidity.

RESULTS:

During the study period there were 8450 nulliparous deliveries. 2668 (31.6%) delivered between midnight and 08.00 h, and 5782 (68.4%) outside of these hours. There was a significant difference between the time periods in the number of babies born with a cord pH <7.1: 10.8% (44/406) of babies were born between midnight and 08.00 h, and 6.3% (63/1007) of babies were born outside these hours (p = 0.003). There was no significant difference in terms of Apgar score <7 at 5 min (p = 0.17). There was a trend toward a larger number of anal sphincter injuries occurring between midnight and 08.00 h (3% vs. 2.3%; p = 0.05).

CONCLUSION:

Our findings suggest that infants are more likely to be born with a pH <7.1 and there was a trend toward an increased rate of anal sphincter injury during time periods when staffing levels are low and clinician fatigue may play a role in decision-making and patient management. This may play a role in service provision planning and staff recruitment.

© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

KEYWORDS:

Emergency; asphyxia; fetal outcome; maternal outcome; out of hours; risk management; sphincter injury

PMID:
24266619
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing
    Loading ...
    Write to the Help Desk