Abstract:
A multifaceted intervention at all six obstetric units in the Stockholm Health Region was performed in 2008–2011 in order to increase safety for the newborn infants. Case-controlled criterion-based reviews of care processes during labor and delivery have been used to assess factors associated with suboptimal care during labor and delivery. Categories of increased risk of adverse outcome during labor and delivery were defined. Cases with low Apgar scores and healthy controls were scrutinized and compared to data from a study with an identical design performed before the intervention. The risk of suboptimal care increased twice among controls and three times among cases when reviewing specific criteria after a multifaceted intervention. There are still gaps in care processes that need attention. Improving guidelines is important but not enough alone, and the management of fetal surveillance needs further improvement. The complexity of reviewing care processes using criterion-based research methodology is highlighted.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
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Supplemental Material:
The online version of this article (DOI: https://doi.org/10.1515/jpm-2016-0301) offers supplementary material, available to authorized users.
©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review article
- Fetal cardiac tumors: clinical features, management and prognosis
- Original articles – Obstetrics
- Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection
- Gaps in obstetric care processes – we can only improve what is being measured
- Tokophobia (fear of childbirth): prevalence and risk factors
- Adjuvant administration of 17-α-hydroxy-progesterone caproate in women with three or more second trimester pregnancy losses undergoing cervical cerclage is no more effective than cerclage alone
- The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?
- NLRP genes and their role in preeclampsia and multi-locus imprinting disorders
- Original articles – Fetus
- Diagnostic value of perinatal autopsies: analysis of 486 cases
- Feto-maternal osmotic balance at term. A prospective observational study
- Original articles – Newborn
- Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section
- Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark
- Critical congenital heart disease screening with a pulse oximetry in neonates
- DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma
- A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio
- Letter to the Editor
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Reply to: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
- Response to the Letter to the Editor, “Risk factors of uterine rupture with a special interest to uterine fundal pressure: methodological issues”
- Re: Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
Articles in the same Issue
- Frontmatter
- Review article
- Fetal cardiac tumors: clinical features, management and prognosis
- Original articles – Obstetrics
- Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection
- Gaps in obstetric care processes – we can only improve what is being measured
- Tokophobia (fear of childbirth): prevalence and risk factors
- Adjuvant administration of 17-α-hydroxy-progesterone caproate in women with three or more second trimester pregnancy losses undergoing cervical cerclage is no more effective than cerclage alone
- The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?
- NLRP genes and their role in preeclampsia and multi-locus imprinting disorders
- Original articles – Fetus
- Diagnostic value of perinatal autopsies: analysis of 486 cases
- Feto-maternal osmotic balance at term. A prospective observational study
- Original articles – Newborn
- Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section
- Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark
- Critical congenital heart disease screening with a pulse oximetry in neonates
- DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma
- A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio
- Letter to the Editor
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Reply to: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
- Response to the Letter to the Editor, “Risk factors of uterine rupture with a special interest to uterine fundal pressure: methodological issues”
- Re: Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review