Labour assessment programs to delay admission to labour wards.
BACKGROUND
The aim of labour assessment programs is to delay hospital admission until labour is in the active phase, and thereby to prevent unnecessary interventions in women who are not in established labour.


OBJECTIVE
The objective of this review was to assess the effects of labour assessment programs that aim to delay hospital admission until labour is in the active phase.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: January 2001.


METHODS
Randomised trials which compare labour assessment programs with direct admission to labour wards.


METHODS
Trial quality was assessed.


RESULTS
One study of 209 women was included. The trial was of excellent quality. Women who were randomised to the labour assessment unit spent less time in the labour ward (weighted mean difference -5.20 hours, 95% confidence interval -7.06, -3.34), were less likely to receive intrapartum oxytocics (odds ratio 0.45, 95% confidence interval 0.25 to 0.80) and analgesia (odds ratio 0.36, 95% confidence interval 0.16 to 0.78), than women who were admitted directly to the labour ward. Women in the labour assessment group reported higher levels of control during labour (weighted mean difference 16.00, 95% confidence interval 7.52 to 24.48). There is insufficient evidence to assess effects on rate of caesarean section and other important measures of maternal and neonatal outcome.


CONCLUSIONS
Labour assessment programs, which aim to delay hospital admission until active labour, may benefit women with term pregnancies.
Lauzon
L
L
30 Blue Forest Lane, Halifax, Nova Scotia, Canada, B4B 1L1. llauzon@ns.sympatico.ca
Hodnett
E
E
D005260:Female; D006760:Hospitalization; D006801:Humans; D007745:Labor Onset; D011247:Pregnancy; D011295:Prenatal Care; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic