The midwife factor in obstetric procedures and neonatal outcome
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P. Konstantiniuk
Abstract
Aims. In the face of major tendency towards midwiferyled- care it was our purpose to investigate the extent of the influence of the midwife on the rates of obstetric procedures and perinatal outcome.
Methods. 5384 consecutive deliveries at the Department of Obstetrics and Gynecology, University of Graz, were enrolled in the study. The following data were collected: mode of delivery, pH of umbilical artery, Apgar score. Firstly, data were investigated for interindividual differences and, secondly, for relationship with age of the midwife as a measure of experience.
Results. Interindividual differences were significant for episiotomy rates (minimum: 31.6%; maximum 76.9%; p<0.001), forceps rates (minimum: 1.7%; maximum 11.1%;p=0.002) and pH of umbilical arteries (minimum: 7.21; maximum: 7.28; p=0.001) but not for cesarean section rates and Apgar scores.
Linear regression analysis was significant between age of midwives and pH of umbilical arteries (p<0.001; r=0.055) and for one-minute Apgar score (p=0.009; r=0.050) but not for episiotomy rates, cesarean section rates, forceps rates and five-minutes Apgar score.
Conclusions. There are large interindividual differences in obstetric intervention rates which cannot be explained by the midwives' age. Provision of health care should be primarily determined by need and not by the personal characteristics of the health care provider, thus interindividual differences should be reduced and more often taken into account when analyzing any kind of data.
Copyright © 2002 by Walter de Gruyter GmbH & Co. KG
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- WAPM-Newsletter No 1/2002
Artikel in diesem Heft
- Cutaneous and subcutaneous infections in newborns due to anaerobic bacteria
- Repeated prenatal corticosteroids reduce glial fibrillary acidic protein in the ovine central nervous system
- Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable? – A blinded controlled audit
- A comparison of clinical variables that predict adverse outcome in term infants with severe respiratory failure randomised to a policy of extracorporeal membrane oxygenation or to conventional neonatal intensive care
- Experience with first level ultrasound and echocardiography for a selected and an unselected population
- Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy
- The midwife factor in obstetric procedures and neonatal outcome
- Cerebral intracellular calcium concentrations in asphyxiated rat fetuses resuscitated with oxygen
- V-shaped deceleration differs in the pattern of carotid blood flow from variable deceleration provoked by cord compression
- Sudden intractable respiratory failure in extremely low birth weight infants with H-type tracheoesophageal fistula
- Neuropathological features of the brain in acardius acormus
- Transient postpartum diabetes insipidus in twin pregnancy associated with HELLP syndrome
- Congress Calendar
- WAPM-Newsletter No 1/2002
