PubMed · 10241031
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M Clark, D Shapiro. 1979-04-23. Labor-saving devices.. https://pubmed.ncbi.nlm.nih.gov/10241031/
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The aim of the study was to compare the influence of foetal weight on the outcome of a prolonged pregnancy. The study group consisted of all women delivered after a prolonged pregnancy at the Dept. of Obstetrics, Herning Central Hospital, during the period from 1.1.1993 to 31.3.1999, stratified by foetal weight. Five-hundred and eighty women were included. Women who gave birth to a child with birthweight less than 3.5 kg were more frequently given oxytocin infusions, and more children were transferred to the neonatal care unit. Heavy children weighing at least 4.5 kg were more frequently delivered by Cesarean section. In all groups very few children had low Apgar scores. When comparing the study population to a population of women giving birth after a completely normal pregnancy, significantly more grade 3-4 perineal ruptures and intrumental deliveries were found in the study group. In conclusion, foetal weight seems to be a poor predictor of the outcome after prolonged pregnancy. Prolonged pregnancy is associated with more instrumental deliveries and perineal ruptures.
OBJECTIVE: To compare the risk profile of women receiving public and private obstetric care and to compare the rates of obstetric intervention among women at low risk in these groups. DESIGN: Population based descriptive study. SETTING: New South Wales, Australia. SUBJECTS: All 171,157 women having a live baby during 1996 and 1997. INTERVENTIONS: Epidural, augmentation or induction of labour, episiotomy, and births by forceps, vacuum, or caesarean section. MAIN OUTCOME MEASURES: Risk profile of public and private patients, intervention rates, and the accumulation of interventions by both patient and hospital classification (public or private). RESULTS: Overall, the frequency of women classified as low risk was similar (48%) among those choosing private obstetric care and those receiving standard care in a public hospital. Among low risk women, rates of obstetric intervention were highest in private patients in private hospitals, lowest in public patients, and generally intermediate for private patients in public hospitals. Among primiparas at low risk, 34% of private patients in private hospitals had a forceps or vacuum delivery compared with 17% of public patients. For multiparas the rates were 8% and 3% respectively. Private patients were significantly more likely to have interventions before birth (epidural, induction or augmentation) but this alone did not account for the increased interventions at birth, particularly the high rates of instrumental births. CONCLUSIONS: Public patients have a lower chance of an instrumental delivery. Women should have equal access to quality maternity services, but information on the outcomes associated with the various models of care may influence their choices.
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