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

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC
Michael C KleinStefan Grzybowski

Abstract

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. 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. 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. Women under the care of family physicians with a practice pattern of early admission were more likely to receive electr...Continue Reading

Citations

Apr 4, 2016·BMC Pregnancy and Childbirth·Gillian E HanleyPatricia A Janssen
Jan 19, 2011·Acta Obstetricia Et Gynecologica Scandinavica·Miha LucovnikRobert E Garfield
Nov 5, 2013·Computational and Mathematical Methods in Medicine·Miha LucovnikRobert E Garfield
Jun 3, 2014·BMC Pregnancy and Childbirth·Patricia A Janssen, Sandra Weissinger
Apr 12, 2016·Journal of Midwifery & Women's Health·Ellen L TildenChristopher S Lee
Apr 21, 2017·The Cochrane Database of Systematic Reviews·Shinobu KobayashiRintaro Mori
Dec 2, 2006·Obstetrics and Gynecology·Patricia A JanssenJohn A Zupancic
Nov 18, 2015·Acta Obstetricia Et Gynecologica Scandinavica·Andreja Trojner BregarRobert E Garfield
Mar 30, 2020·Best Practice & Research. Clinical Obstetrics & Gynaecology·Vanora HundleySarah J Buckley
May 29, 2021·Midwifery·Holly Lovell, James Matthew Harris

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