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The outcome of midwife-led labor in low-risk women within an obstetric referral unit.
Ferrazzi, Enrico; Visconti, Elena; Paganelli, Andrea M; Campi, Carmen M; Lazzeri, Cristina; Cirillo, Federico; Livio, Stefania; Piola, Cinzia.
Afiliação
  • Ferrazzi E; a Department of the Women , Mother and Neonate, Buzzi Mother and Child Hospital, Medical School of Biomedical and Clinical Sciences, University of Milan , Milan , Italy.
J Matern Fetal Neonatal Med ; 28(13): 1530-6, 2015 Sep.
Article em En | MEDLINE | ID: mdl-25190281
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2015 Tipo de documento: Article