Labor augmentation in an Egyptian teaching hospital.
OBJECTIVE
The study documented facility-based obstetric practices for normal labor in Egypt for the first time, to determine their relationship to evidence-based medicine. This paper describes the labor augmentation pattern observed.


METHODS
176 cases of normal labor were observed by medically-trained observers using a checklist. Ward activities were also documented. Observed women were interviewed postpartum and all findings were shared with the providers for their feedback.


RESULTS
Labor was augmented in 91% (165) of the labors observed; this was inappropriate for 93% or 154 women. Reasons for inappropriateness were: oxytocin ordered at the first vaginal exam (41%); in spite of intact membranes (36%), at the time of membrane rupture (42%), in spite of good progress (24%), or a combination of these. The monitoring of oxytocin-receiving women and their babies was inadequate.


CONCLUSIONS
Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.
Khalil
K
K
The Population Council, Cairo, Egypt. kkhalil@pccairo.org
Cherine
M
M
Elnoury
A
A
Sholkamy
H
H
Breebaart
M
M
Hassanein
N
N
D004534:Egypt; D019317:Evidence-Based Medicine; D005260:Female; D005323:Fetal Monitoring; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D007751:Labor, Induced; D010121:Oxytocin; D011247:Pregnancy; D018590:Uterine Monitoring
D010121:Oxytocin