Labor augmentation in an Egyptian teaching hospital
Khalil, K.; Cherine, M.; Elnoury, A.; Sholkamy, H.; Breebaart, M.; Hassanein, N.
International Journal of Gynaecology and Obstetrics the Official Organ of the International Federation of Gynaecology and Obstetrics 85(1): 74-80
2004
ISSN/ISBN: 0020-7292 PMID: 15050479 DOI: 10.1016/s0020-7292(03)00311-4Document Number: 233071
The study documented facility-based obstetric practices for normal labor in Egypt for the first time, to determine their relationship to evidence-based medicine. This paper describes the labor augmentation pattern observed. 176 cases of normal labor were observed by medically-trained observers using a checklist. Ward activities were also documented. Observed women were interviewed postpartum and all findings were shared with the providers for their feedback. Labor was augmented in 91% (165) of the labors observed; this was inappropriate for 93% or 154 women. Reasons for inappropriateness were: oxytocin ordered at the first vaginal exam (41%); in spite of intact membranes (36%), at the time of membrane rupture (42%), in spite of good progress (24%), or a combination of these. The monitoring of oxytocin-receiving women and their babies was inadequate. Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.