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.
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.
Authors: Ellen L Tilden; Julia C Phillippi; Mia Ahlberg; Tekoa L King; Mekhala Dissanayake; Christopher S Lee; Jonathan M Snowden; Aaron B Caughey Journal: Birth Date: 2019-03-28 Impact factor: 3.689
Authors: Miha Lucovnik; Ruben J Kuon; Linda R Chambliss; William L Maner; Shao-Qing Shi; Leili Shi; James Balducci; Robert E Garfield Journal: Acta Obstet Gynecol Scand Date: 2010-12-07 Impact factor: 3.636
Authors: Helen Cheyne; Vanora Hundley; Dawn Dowding; J Martin Bland; Paul McNamee; Ian Greer; Maggie Styles; Carol A Barnett; Graham Scotland; Catherine Niven Journal: BMJ Date: 2008-12-08
Authors: Rafael T Mikolajczyk; Jun Zhang; Jagteshwar Grewal; Linda C Chan; Antje Petersen; Mechthild M Gross Journal: Front Med (Lausanne) Date: 2016-06-27