Is outcome for low risk obstetric patients influenced by parity and intervention?
Maternal and perinatal morbidity were examined to assess the influence of parity and intervention procedures among 1032 women considered low risk at commencement of labour. A diagnosis of fetal distress, failure to progress during labour, maternal problems after delivery and consultation with or transfer of the neonate to a paediatrician occurred more frequently amongst nulliparous women (p less than 0.001). Failure to progress in labour was found to be influenced by parity (primigravida), maternal age (less than 20 years) and also by the use of epidural anaesthetic for pain relief (p less than 0.001). Prevalence of abnormal delivery was found to be influenced by parity (primigravida), failure to progress in labour and diagnosis of fetal distress. The use of epidural anaesthesia for pain relief was also found to increase the rate of abnormal delivery (p less than 0.001). Statistically significant differences occurred between the groups of patients, with patients of private specialists having the highest rates for induction (34%), use of epidural for pain relief (40%) and abnormal delivery (46%).
Tilyard
M W
MW
Department of General Practice, University of Otago Medical School, Dunedin.
Williams
S
S
Seddon
R J
RJ
Oakley
M E
ME
Murdoch
J C
JC
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D036861:Delivery, Obstetric / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005316:Fetal Distress / Q000150:complications / Q000175:diagnosis; D005323:Fetal Monitoring; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D009774:Obstetrics; D010298:Parity; D010821:Physicians, Family; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods*; D011644:Puerperal Disorders / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health; D014504:Urban Health