Change in risk status during labor in a large Norwegian obstetric department: a prospective study.
OBJECTIVE
This study aimed to observe risk status on admission to hospital and change in risk status during labor.


METHODS
A prospective observational study allocating all women into low-risk and high-risk groups on admittance to hospital and during labor based on prespecified risk criteria.


METHODS
Department of Obstetrics and Gynecology in a district hospital.


METHODS
All 6406 deliveries from 2 May 2004 to 30 September 2006.


METHODS
A special form was filled out for all women admitted to the department in labor classifying them as either low or high risk. A change in risk status during labor was also recorded.


METHODS
Risk status (low and high risk) on admittance to hospital and change in risk status during first stage of labor.


RESULTS
On admittance, 67% of women with an intended vaginal delivery were low risk. During the first stage of labor, 41% of the low-risk women changed risk status. Use of epidural anesthesia gave rise to 73% of the risk changes during the first stage of labor and use of oxytocin caused 12%.


CONCLUSIONS
Two-thirds of the women were low risk before labor, and 39% of these remained low-risk at the end of the first stage of labor. The main reason for a change of risk status in the obstetric department was the use of epidural anesthesia.
Department of Obstetrics and Gynecology, Baerum Hospital, Baerum, Norway. Tonje.Lippert@vestreviken.no
Tonje
T
Lippert
Ellen
E
Nesje
Karen Sofie
KS
Koss
Pål
P
Oian
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D006801:Humans; D007747:Labor Stage, First; D008470:Meconium; D009664:Norway; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010120:Oxytocics / Q000627:therapeutic use; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D018570:Risk Assessment
D010120:Oxytocics; D010121:Oxytocin