Evidence-based labor and delivery management.
Publication/Presentation Date
11-1-2008
Abstract
Our objective was to provide evidence-based guidance for management decisions during labor and delivery. We performed MEDLINE, PubMed, and COCHRANE searches with the terms labor, delivery, pregnancy, randomized trials, plus each management aspect of labor and delivery (eg, early admission). Each management step of labor and delivery was reviewed separately. Evidence-based good quality data favor hospital births, delayed admission, support by doula, training birth assistants in developing countries, and upright position in the second stage. Home-like births, enema, shaving, routine vaginal irrigation, early amniotomy, "hands-on" method, fundal pressure, and episiotomy can be associated with complications without sufficient benefits and should probably be avoided. We conclude that labor and delivery interventions supported by good quality data as just described should be routinely performed. All aspects with lower data quality should be researched with adequately powered and designed trials.
Volume
199
Issue
5
First Page
445
Last Page
454
ISSN
1097-6868
Published In/Presented At
Berghella, V., Baxter, J. K., & Chauhan, S. P. (2008). Evidence-based labor and delivery management. American journal of obstetrics and gynecology, 199(5), 445–454. https://doi.org/10.1016/j.ajog.2008.06.093
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
18984077
Department(s)
Administration and Leadership
Document Type
Article