The impact of a new standard labor protocol on maternal and neonatal outcomes
Purpose To analyze the clinical outcomes following the implementation of a new standard labor procedure. Methods This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under a...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2017-12, Vol.296 (6), p.1085-1090 |
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| creator | Wang, Dingran Ye, Shenglong Tao, Liyuan Wang, Yongqing |
| description | Purpose
To analyze the clinical outcomes following the implementation of a new standard labor procedure.
Methods
This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention. We also compared the average number of days spent in the hospital, the incidence of medical disputes and hospitalization expenses.
Results
The cesarean section rates for the study and control groups were 19.29% (401/2079) and 33.53% (753/2246), respectively (
P
|
| doi_str_mv | 10.1007/s00404-017-4536-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1943283344</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1943283344</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-1c76fc022929fbba5b109b7ed4777695f3954221e92ff0b662f574bfca9663073</originalsourceid><addsrcrecordid>eNp1kMtKAzEUhoMotlYfwI0E3LgZPblMMllK8QYVN3UdMmmiLTOTmswgvr0Z6gUEVzkh3_lzzofQKYFLAiCvEgAHXgCRBS-ZKGAPTQlntABJyD6aghprEHKCjlLaABBaVeIQTWileMU4maLH5avD63ZrbI-DxwZ37h2n3nQrE1e4MXWIeBtDH2xocOhwa3oXO9PgTGQ2dKbPlzD0NrQuHaMDb5rkTr7OGXq-vVnO74vF093D_HpRWCZpXxArhbdAqaLK17UpawKqlm7FpZRClZ6pklNKnKLeQy0E9aXktbdGCcFAshm62OXm0d4Gl3rdrpN1TWPySEPSRGULFWOcZ_T8D7oJw7hB0pQKUlIOAJkiO8rGkFJ0Xm_jujXxQxPQo2u9c62zaz261mPP2VfyULdu9dPxLTcDdAek_NS9uPj79f-pn40bh34</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261524000</pqid></control><display><type>article</type><title>The impact of a new standard labor protocol on maternal and neonatal outcomes</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wang, Dingran ; Ye, Shenglong ; Tao, Liyuan ; Wang, Yongqing</creator><creatorcontrib>Wang, Dingran ; Ye, Shenglong ; Tao, Liyuan ; Wang, Yongqing</creatorcontrib><description>Purpose
To analyze the clinical outcomes following the implementation of a new standard labor procedure.
Methods
This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention. We also compared the average number of days spent in the hospital, the incidence of medical disputes and hospitalization expenses.
Results
The cesarean section rates for the study and control groups were 19.29% (401/2079) and 33.53% (753/2246), respectively (
P
< 0.05). The main indications for a cesarean section in the study group were arrest of the active phase of labor, fetal distress and intrapartum fever; the percentages of each indication were significantly different from those of the control group (
P
< 0.001). The rates of postpartum hemorrhage in the study group and control group were 7.74% (130/1678) and 8.1% (121/1493), respectively (
P
= 0.710). The incidence rates of severe perineal lacerations were 0.48% (8/1678) for the study group and 0.2% (3/1493) for the control group (
P
= 0.187). The rates of forceps use were 4.29% (72/1678) in the study group and 2.41% (36/1493) in the control group (
P
= 0.004). The incidence rate of fetal distress in the study group was 6.24% (169/2709) and 4.67% (105/2246) (
P
= 0.006) in the control group. No significant difference was observed in the incidence of neonatal asphyxia and pediatric interventions between the two groups (0.74% (20/2709) vs. 8.12% (220/2709) and 17 (0.76%) vs. 161 (7.17%), respectively). The average length of hospital stay was 4.74 ± 1.15 and 2.13 ± 1.23 days (
P
< 0.01). The incidence of medical disputes was significantly different between the two groups: 1.44% (30/2079) in the study group and 0.53% (12/2246) in the control group (
P
< 0.01). The hospitalization expenses were 5401.29 ± 296.33 yuan in the study group and 5253.53 ± 3655.79 yuan in the control group (
P
= 0.06).
Conclusions
The implementation of the new labor protocol reduced the cesarean section rate without negatively impacting maternal and neonatal outcomes. In practice, bed turnover and the hospital utilization rate should be better controlled, patient–doctor communication should be strengthened and the quality of obstetrical service should be improved.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-017-4536-0</identifier><identifier>PMID: 28948341</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cesarean section ; Cesarean Section - statistics & numerical data ; China ; Delivery, Obstetric - methods ; Endocrinology ; Female ; Fetal Distress ; Guideline Adherence ; Gynecology ; Health risk assessment ; Human Genetics ; Humans ; Labor, Obstetric ; Length of Stay ; Maternal-Fetal Medicine ; Medicine ; Medicine & Public Health ; Obstetrics/Perinatology/Midwifery ; Pediatrics ; Postpartum Hemorrhage - epidemiology ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Outcome - epidemiology ; Retrospective Studies</subject><ispartof>Archives of gynecology and obstetrics, 2017-12, Vol.296 (6), p.1085-1090</ispartof><rights>Springer-Verlag GmbH Germany 2017</rights><rights>Archives of Gynecology and Obstetrics is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-1c76fc022929fbba5b109b7ed4777695f3954221e92ff0b662f574bfca9663073</citedby><cites>FETCH-LOGICAL-c372t-1c76fc022929fbba5b109b7ed4777695f3954221e92ff0b662f574bfca9663073</cites><orcidid>0000-0001-9362-694X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-017-4536-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-017-4536-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28948341$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Dingran</creatorcontrib><creatorcontrib>Ye, Shenglong</creatorcontrib><creatorcontrib>Tao, Liyuan</creatorcontrib><creatorcontrib>Wang, Yongqing</creatorcontrib><title>The impact of a new standard labor protocol on maternal and neonatal outcomes</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
To analyze the clinical outcomes following the implementation of a new standard labor procedure.
Methods
This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention. We also compared the average number of days spent in the hospital, the incidence of medical disputes and hospitalization expenses.
Results
The cesarean section rates for the study and control groups were 19.29% (401/2079) and 33.53% (753/2246), respectively (
P
< 0.05). The main indications for a cesarean section in the study group were arrest of the active phase of labor, fetal distress and intrapartum fever; the percentages of each indication were significantly different from those of the control group (
P
< 0.001). The rates of postpartum hemorrhage in the study group and control group were 7.74% (130/1678) and 8.1% (121/1493), respectively (
P
= 0.710). The incidence rates of severe perineal lacerations were 0.48% (8/1678) for the study group and 0.2% (3/1493) for the control group (
P
= 0.187). The rates of forceps use were 4.29% (72/1678) in the study group and 2.41% (36/1493) in the control group (
P
= 0.004). The incidence rate of fetal distress in the study group was 6.24% (169/2709) and 4.67% (105/2246) (
P
= 0.006) in the control group. No significant difference was observed in the incidence of neonatal asphyxia and pediatric interventions between the two groups (0.74% (20/2709) vs. 8.12% (220/2709) and 17 (0.76%) vs. 161 (7.17%), respectively). The average length of hospital stay was 4.74 ± 1.15 and 2.13 ± 1.23 days (
P
< 0.01). The incidence of medical disputes was significantly different between the two groups: 1.44% (30/2079) in the study group and 0.53% (12/2246) in the control group (
P
< 0.01). The hospitalization expenses were 5401.29 ± 296.33 yuan in the study group and 5253.53 ± 3655.79 yuan in the control group (
P
= 0.06).
Conclusions
The implementation of the new labor protocol reduced the cesarean section rate without negatively impacting maternal and neonatal outcomes. In practice, bed turnover and the hospital utilization rate should be better controlled, patient–doctor communication should be strengthened and the quality of obstetrical service should be improved.</description><subject>Cesarean section</subject><subject>Cesarean Section - statistics & numerical data</subject><subject>China</subject><subject>Delivery, Obstetric - methods</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Fetal Distress</subject><subject>Guideline Adherence</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Labor, Obstetric</subject><subject>Length of Stay</subject><subject>Maternal-Fetal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Pediatrics</subject><subject>Postpartum Hemorrhage - epidemiology</subject><subject>Practice Guidelines as Topic</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Retrospective Studies</subject><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtKAzEUhoMotlYfwI0E3LgZPblMMllK8QYVN3UdMmmiLTOTmswgvr0Z6gUEVzkh3_lzzofQKYFLAiCvEgAHXgCRBS-ZKGAPTQlntABJyD6aghprEHKCjlLaABBaVeIQTWileMU4maLH5avD63ZrbI-DxwZ37h2n3nQrE1e4MXWIeBtDH2xocOhwa3oXO9PgTGQ2dKbPlzD0NrQuHaMDb5rkTr7OGXq-vVnO74vF093D_HpRWCZpXxArhbdAqaLK17UpawKqlm7FpZRClZ6pklNKnKLeQy0E9aXktbdGCcFAshm62OXm0d4Gl3rdrpN1TWPySEPSRGULFWOcZ_T8D7oJw7hB0pQKUlIOAJkiO8rGkFJ0Xm_jujXxQxPQo2u9c62zaz261mPP2VfyULdu9dPxLTcDdAek_NS9uPj79f-pn40bh34</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Wang, Dingran</creator><creator>Ye, Shenglong</creator><creator>Tao, Liyuan</creator><creator>Wang, Yongqing</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9362-694X</orcidid></search><sort><creationdate>20171201</creationdate><title>The impact of a new standard labor protocol on maternal and neonatal outcomes</title><author>Wang, Dingran ; Ye, Shenglong ; Tao, Liyuan ; Wang, Yongqing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-1c76fc022929fbba5b109b7ed4777695f3954221e92ff0b662f574bfca9663073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cesarean section</topic><topic>Cesarean Section - statistics & numerical data</topic><topic>China</topic><topic>Delivery, Obstetric - methods</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Fetal Distress</topic><topic>Guideline Adherence</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Labor, Obstetric</topic><topic>Length of Stay</topic><topic>Maternal-Fetal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Pediatrics</topic><topic>Postpartum Hemorrhage - epidemiology</topic><topic>Practice Guidelines as Topic</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Dingran</creatorcontrib><creatorcontrib>Ye, Shenglong</creatorcontrib><creatorcontrib>Tao, Liyuan</creatorcontrib><creatorcontrib>Wang, Yongqing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Dingran</au><au>Ye, Shenglong</au><au>Tao, Liyuan</au><au>Wang, Yongqing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of a new standard labor protocol on maternal and neonatal outcomes</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>296</volume><issue>6</issue><spage>1085</spage><epage>1090</epage><pages>1085-1090</pages><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
To analyze the clinical outcomes following the implementation of a new standard labor procedure.
Methods
This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention. We also compared the average number of days spent in the hospital, the incidence of medical disputes and hospitalization expenses.
Results
The cesarean section rates for the study and control groups were 19.29% (401/2079) and 33.53% (753/2246), respectively (
P
< 0.05). The main indications for a cesarean section in the study group were arrest of the active phase of labor, fetal distress and intrapartum fever; the percentages of each indication were significantly different from those of the control group (
P
< 0.001). The rates of postpartum hemorrhage in the study group and control group were 7.74% (130/1678) and 8.1% (121/1493), respectively (
P
= 0.710). The incidence rates of severe perineal lacerations were 0.48% (8/1678) for the study group and 0.2% (3/1493) for the control group (
P
= 0.187). The rates of forceps use were 4.29% (72/1678) in the study group and 2.41% (36/1493) in the control group (
P
= 0.004). The incidence rate of fetal distress in the study group was 6.24% (169/2709) and 4.67% (105/2246) (
P
= 0.006) in the control group. No significant difference was observed in the incidence of neonatal asphyxia and pediatric interventions between the two groups (0.74% (20/2709) vs. 8.12% (220/2709) and 17 (0.76%) vs. 161 (7.17%), respectively). The average length of hospital stay was 4.74 ± 1.15 and 2.13 ± 1.23 days (
P
< 0.01). The incidence of medical disputes was significantly different between the two groups: 1.44% (30/2079) in the study group and 0.53% (12/2246) in the control group (
P
< 0.01). The hospitalization expenses were 5401.29 ± 296.33 yuan in the study group and 5253.53 ± 3655.79 yuan in the control group (
P
= 0.06).
Conclusions
The implementation of the new labor protocol reduced the cesarean section rate without negatively impacting maternal and neonatal outcomes. In practice, bed turnover and the hospital utilization rate should be better controlled, patient–doctor communication should be strengthened and the quality of obstetrical service should be improved.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28948341</pmid><doi>10.1007/s00404-017-4536-0</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-9362-694X</orcidid></addata></record> |
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| ispartof | Archives of gynecology and obstetrics, 2017-12, Vol.296 (6), p.1085-1090 |
| issn | 0932-0067 1432-0711 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Cesarean section Cesarean Section - statistics & numerical data China Delivery, Obstetric - methods Endocrinology Female Fetal Distress Guideline Adherence Gynecology Health risk assessment Human Genetics Humans Labor, Obstetric Length of Stay Maternal-Fetal Medicine Medicine Medicine & Public Health Obstetrics/Perinatology/Midwifery Pediatrics Postpartum Hemorrhage - epidemiology Practice Guidelines as Topic Pregnancy Pregnancy Outcome - epidemiology Retrospective Studies |
| title | The impact of a new standard labor protocol on maternal and neonatal outcomes |
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