Obstetrics and gynecology · 2003
Is there an obstetric July phenomenon?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Myles Thomas D
Аннотация
OBJECTIVE: To estimate whether variations in intrapartum management and complications exist with regard to the time of delivery within the academic year.
METHODS: The delivery records of 7814 patients were separated by both term half year and quarter. Statistical comparisons were made using chi2 tests of association (P < .05) with respect to the academic time of the year and perineal trauma (third- or fourth-degree tear), episiotomy usage, cesarean delivery, postpartum hemorrhage, chorioamnionitis, shoulder dystocia, neonatal intensive care unit admission, 1- or 5-minute Apgar scores less than 7, and low umbilical cord pH.
RESULTS: There were 4082 deliveries in the first half and 3732 in the second half of the year from April 1996 through March 1999. The first half-year overall cesarean rate was higher (15.8% versus 14.3%, P < .03). Primary cesarean rates were similar. No other differences were found by term half year. More perineal trauma was noted in the fourth quarter (first 3.3%, second 4.5%, third 3.7%, fourth 5.5%, P < .037). Episiotomy usage was higher in both the first and fourth quarters (13.0%, 11.3%, 10.6%, and 14.8%, P < .002). More cases of chorioamnionitis occurred in the fourth quarter (first 3.4%, second 3.1%, third 2.6%, fourth 4.0%, P < .038, third versus fourth quarter). Chorioamnionitis occurred more frequently in July (July 5.0% versus August-June 3.1%, P < .005). There were no other clinically significant differences. Neonatal outcomes were not affected by academic time of year.
CONCLUSION: Although small differences in outcome exist with respect to the academic time of the year, the timing of these differences indicates that there is not a "July phenomenon" in obstetrics at our institution.
METHODS: The delivery records of 7814 patients were separated by both term half year and quarter. Statistical comparisons were made using chi2 tests of association (P < .05) with respect to the academic time of the year and perineal trauma (third- or fourth-degree tear), episiotomy usage, cesarean delivery, postpartum hemorrhage, chorioamnionitis, shoulder dystocia, neonatal intensive care unit admission, 1- or 5-minute Apgar scores less than 7, and low umbilical cord pH.
RESULTS: There were 4082 deliveries in the first half and 3732 in the second half of the year from April 1996 through March 1999. The first half-year overall cesarean rate was higher (15.8% versus 14.3%, P < .03). Primary cesarean rates were similar. No other differences were found by term half year. More perineal trauma was noted in the fourth quarter (first 3.3%, second 4.5%, third 3.7%, fourth 5.5%, P < .037). Episiotomy usage was higher in both the first and fourth quarters (13.0%, 11.3%, 10.6%, and 14.8%, P < .002). More cases of chorioamnionitis occurred in the fourth quarter (first 3.4%, second 3.1%, third 2.6%, fourth 4.0%, P < .038, third versus fourth quarter). Chorioamnionitis occurred more frequently in July (July 5.0% versus August-June 3.1%, P < .005). There were no other clinically significant differences. Neonatal outcomes were not affected by academic time of year.
CONCLUSION: Although small differences in outcome exist with respect to the academic time of the year, the timing of these differences indicates that there is not a "July phenomenon" in obstetrics at our institution.