Differences in management and results in term-delivery in nine European referral hospitals: descriptive study.
OBJECTIVE
To compose obstetric interventions around Europe.


METHODS
A survey of obstetric practices, logistics and statistical outcomes in nine tertiary referral hospitals in Europe between November 1999 and October 2000.


RESULTS
There was wide variation in the management of pre labour rupture of the membranes at term, methods of analgesia, induction of labour, and mode of cephalic and breech delivery. Midwives practised normal deliveries at only three sites. Rates of epidural analgesia varied from 0% in Perugia to 98% in Barcelona, instrumental delivery from 3% in Perugia to 40% in Barcelona, episiotomy from 9.7% in Uppsala to 58% in Perugia, caesarean section before and during labour from 12% in Paris to 32% in Athens, vaginal breech delivery from 15% in Barcelona to 70% in Paris. The percentage of primipara varied from 40% in Uppsala to 65% in Perugia; birth weight under 2500g from 5% in Uppsala to 23% in Amsterdam, over 4000g from 3.1% in Athens to 22% in Uppsala and gestational age less than 37 weeks from 6% in Dublin to 26% in Amsterdam.


CONCLUSIONS
There are considerable differences in obstetric practices without any major difference in maternal and perinatal mortality.
Alran
Séverine
S
Department of Obstetrics and Gynaecology, Hospital Robert Debré, 19 Boulevard Sérurier, Paris 75019, France.
Sibony
Olivier
O
Oury
Jean-François
JF
Luton
Dominique
D
Blot
Philippe
P
D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000379:methods; D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods*; D004841:Episiotomy / Q000706:statistics & numerical data; D005060:Europe; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006761:Hospitals; D006801:Humans; D007751:Labor, Induced; D007743:Labor, Obstetric; D008880:Midwifery; D009774:Obstetrics / Q000379:methods / Q000458:organization & administration; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011795:Surveys and Questionnaires