Data di Pubblicazione:
2015
Citazione:
The outcome of midwife-led labor in low-risk women within an obstetric referral unit / E. Ferrazzi, E. Visconti, A.M. Paganelli, C.M. Campi, C. Lazzeri, F. Cirillo, S. Livio, C. Piola. - In: THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE. - ISSN 1476-7058. - 28:13(2015), pp. 1530-1536. [10.3109/14767058.2014.958995]
Abstract:
Objective: To analyze maternal and neonatal outcomes of midwife-led labor in low-risk women at term. Methods: Prospective observational cohort of 1788 singleton low-risk pregnancies in spontaneous term labor, managed according to a specific midwife-led labor protocol. Primary outcomes were mode of delivery, episiotomy, 3rd-4th degree lacerations, post-partum hemorrhage (PPH), need for blood transfusions, pH and Apgar score and NICU admissions. Results: A total 1754 low-risk women (50.3% of all deliveries) were included in the analysis. Epidural analgesia was performed in 29.8% of cases. The rate of cesarean section was 3.7%. Episiotomy was performed in 17.6% of women. PPH > 1000 ml occurred in 1.7% of cases. 3.2% and 0.3% of the cases had an Apgar score <7 and pH < 7.10, respectively, while 0.3% of the newborns were admitted to NICU. Consultant-led labor was required for emerging risk factors during 1st and 2nd stage of labor in 16.1 and 8.6% of cases, respectively. Although maternal outcome were worse in women with emerging risk factors in labor, while neonatal outcomes were not affected by the presence these complications. Conclusions: In hospital settings, midwife-led labor in low-risk women might unfold its major advantages without additional risks of medicalization for the mother and the neonate.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Apgar score; cesarean section; labor and delivery; midwifery; women's health issues
Elenco autori:
E. Ferrazzi, E. Visconti, A.M. Paganelli, C.M. Campi, C. Lazzeri, F. Cirillo, S. Livio, C. Piola
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