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.
Titolo: | The outcome of midwife-led labor in low-risk women within an obstetric referral unit |
Autori: | LIVIO, STEFANIA (Penultimo) |
Parole Chiave: | Apgar score; cesarean section; labor and delivery; midwifery; women's health issues |
Settore Scientifico Disciplinare: | Settore MED/40 - Ginecologia e Ostetricia |
Data di pubblicazione: | 2015 |
Rivista: | |
Tipologia: | Article (author) |
Data ahead of print / Data di stampa: | 19-set-2014 |
Digital Object Identifier (DOI): | 10.3109/14767058.2014.958995 |
Appare nelle tipologie: | 01 - Articolo su periodico |
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