A comparative study between the use of analgesia/anaesthesia and of episiotomy in women delivered under consultant supervision or general practitioner care.
A retrospective cohort study based on obstetric records was performed, to compare the use of analgesia/anaesthesia during labour by consultants and general practitioners. The episiotomy rates for the two groups were also compared. 111 general practitioner patients were identified and these were matched with 111 consultant patients. No difference was found between the two groups for duration of stages I or II. The rates for episiotomy, 1 degree or 2 degrees tear or intact perineum were the same in each group. Women delivered under consultant supervision used more entonox than women delivered under general practitioner care, but this was counterbalanced by an increased use of pethidine in the latter group. No difference was found between the two groups with regard to the use of epidurals. There was an increased use of local anaesthetic by general practitioners. This was due to general practitioners preferring to use local anaesthetic for suturing after an epidural had worn off, whereas hospital doctors preferred to top-up the epidural to provide anaesthesia for suturing. This study supports the view that women delivered under the care of their own general practitioner in a hospital obstetric unit fare no worse than similar women delivered under consultant supervision. The former group have the advantage of continuity of care from their general practitioner.
F M
FM
McCracken
R J
RJ
Madeley
J S
JS
McCracken
D000773:Anesthesia, Obstetrical / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004739:England; D004841:Episiotomy / Q000706:statistics & numerical data*; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D009774:Obstetrics / Q000379:methods*; D011247:Pregnancy; D012017:Referral and Consultation; D012189:Retrospective Studies