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J Obstet Gynaecol Can. 2004 Jul;26(7):641-5.

The effect of family physician timing of maternal admission on procedures in labour and maternal and infant morbidity.

Author information

1
Department of Family Practice, University of British Columbia, Vancouver, BC.

Abstract

OBJECTIVE:

To determine if a family physician practice pattern of early admission is associated with increased rates of intervention in labour and delivery, and/or adverse maternal and newborn outcomes.

METHOD:

A retrospective cohort study compared women under the care of family physicians having 50% or more of their patients admitted to the labour and delivery unit "early" (defined as a cervical dilatation of < or =3 cm) to women under the care of family physicians having less than 50% of their patients admitted "early." Outcome measures included labour intervention rates and maternal and neonatal morbidity.

RESULTS:

After adjusting for maternal characteristics, care by family physicians with a practice of early admission was associated with increased rates of electronic fetal monitoring (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.27-1.89), epidural analgesia (OR, 1.34; 95% CI, 1.15-1.55), and Caesarean section (OR, 1.33; 95% CI, 1.00-1.65) compared to family physicians with a practice pattern of late admission. Malposition in labour was associated with more interventions in labour than was family physician practice pattern.

CONCLUSION:

Women under the care of family physicians with a practice pattern of early admission were more likely to receive electronic fetal monitoring, epidural analgesia, and Caesarean section than women under the care of family physicians with a practice pattern of late admission. Malposition in labour had a greater effect on procedure use than any other variable in our model.

PMID:
15248933
DOI:
10.1016/s1701-2163(16)30611-9
[Indexed for MEDLINE]

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