Resident consultant presence in labour ward after midnight – a retrospective cohort study of 5318 deliveries
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Jawad Freites
Abstract
Introduction: The Royal College of Obstetricians and Gynaecologists, in their document “The future role of the consultant,” recommended that there should be a resident obstetric consultant present in the labour ward for 24 h in large UK hospitals. There is little work that validates this recommendation. The period from midnight to 08:00 h is the most disruptive to work-life balance.
Objectives: This retrospective study evaluates obstetric outcomes from midnight until 08:00 h in relation to the consultant being a resident or on-call from home over a 3-year period.
Methods: The Hull Royal Infirmary is a obstetric unit delivering more than 5000 babies annually. There are nine consultant obstetricians and three associate specialists who provide cover; nine always go home when on-call and return to the hospital if needed after midnight and three are resident in the hospital for personal reasons. There is a registrar and house officer resident at all times. All birth data are contemporaneously recorded on a database.
Results: A total of 5318 deliveries were studied over a 3-year period (resident consultant, n=1226; consultant on-call from home, n=4092). There were significantly fewer forceps deliveries when the consultant was on-call from home (3.3% vs. 5.1%, odds ratio 0.65, 95% confidence interval 0.48–0.88), but there was no difference in any other delivery outcome (caesarean 14.5% vs. 13.9%). There were no differences between the rates of stillbirth (0.4% vs. 0.4%) and babies born with low Apgar scores (1.4% vs. 1.3%) when the consultant was on-call from home.
Conclusion: There is an increased incidence of forceps delivery when the consultant is resident, but there is no difference in any other obstetric parameter. The recommendation for consultant presence in the labour ward has not been validated by this study.
©2012 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- Masthead
- Masthead
- Original Articles – Obstetrics
- Vaginal progesterone to prevent preterm birth in multiple pregnancy: a randomized controlled trial
- Association of high-sensitivity C-reactive protein serum levels in early pregnancy with the severity of preeclampsia and fetal birth weight
- High-fidelity simulation increases obstetric self-assurance and skills in undergraduate medical students
- Resident consultant presence in labour ward after midnight – a retrospective cohort study of 5318 deliveries
- Carboxyhemoglobin levels in umbilical cord blood of women with pre-eclampsia and intrauterine growth restriction
- Labour epidural analgesia and anti-infectious management of the neonate: a meta-analysis
- What about ST waveform analysis signal quality in the second stage of labor? A case-control study
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- Original Articles – Fetus
- Mode of anaesthesia on fetal acid-base status at caesarean section
- Development of integrative autonomic nervous system function: an investigation based on time correlation in fetal heart rate patterns
- Original Articles – Newborn
- Guttus, tiralatte and téterelle: a history of breast pumps
- Does docosahexaenoic acid (DHA) status in pregnancy have any impact on postnatal growth? Six-year follow-up of a prospective randomized double-blind monocenter study on low-dose DHA supplements
- The evolution of risk factors for respiratory syncytial virus-related hospitalisation in infants born at 32–35 weeks’ gestational age: time-based analysis using data from the FLIP-2 study
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- Low placental weight and risk for fetal distress at birth
- Electrical pacemaker as a safe and feasible method for decreasing the uterine contractions of human preterm labor
- Congress Calendar
- Congress Calendar
- WAPM Newsletter
- WAPM Newsletter
