Reversal of the decision for caesarean section in the second stage of labour on the basis of consultant vaginal assessment.
During a 5-year period there were 32 cases where the vaginal assessment performed by a specialist registrar in the second stage of labour was re-assessed within 15 minutes by a consultant obstetrician. The examination was prompted by a request for permission to perform a caesarean section in the second stage of labour. The results suggest a significant discrepancy between the consultants and the specialist registrar's findings, with 44% of the cases indicating a difference in the position of the head, and 81% a difference in the station of the head. No comment was made about caput or moulding in the majority of cases (94%). The study findings suggest that vaginal examination, like instrumental delivery, is a skill that is being eroded and will require formal instruction to address this problem.
Oláh
K S
KS
Department of Obstetrics and Gynaecology, Warwick Hospital, Lakin Road, Warwick CV34 6BW, UK. karl.olah@btinternet.com
D000328:Adult; D002585:Cesarean Section; D002983:Clinical Competence; D003661:Decision Support Techniques; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D008499:Medical Records; D008505:Medical Staff, Hospital / Q000592:standards; D009774:Obstetrics / Q000592:standards; D011247:Pregnancy; D012017:Referral and Consultation; D012189:Retrospective Studies