title: Labor augmentation in an Egyptian teaching hospital.
abstract: 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.
authors.affiliation: The Population Council, Cairo, Egypt. kkhalil@pccairo.org
authors.forename: K
authors.initials: K
authors.lastname: Khalil
authors.forename: M
authors.initials: M
authors.lastname: Cherine
authors.forename: A
authors.initials: A
authors.lastname: Elnoury
authors.forename: H
authors.initials: H
authors.lastname: Sholkamy
authors.forename: M
authors.initials: M
authors.lastname: Breebaart
authors.forename: N
authors.initials: N
authors.lastname: Hassanein
mesh_terms: 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
chemical_list: D010121:Oxytocin