Tertiary care improves the chance for vaginal delivery in women with preeclampsia - 28/08/11
Abstract |
Objective |
The purpose of this study was to determine whether the level of hospital care affects cesarean delivery rates for women with preeclampsia.
Study design |
We conducted a population-based cohort study using Missouri birth certificate data for 1993 through 1999. Logistic regression was used to analyze data from 13,646 nulliparous women with preeclampsia who were delivered of singleton live births.
Results |
After adjustment was made for gestational age and birth weight, the data showed that women with preeclampsia at primary and secondary hospitals were more likely to be delivered by cesarean delivery (odds ratio, 1.37; 95% CI, 1.24,1.51; and odds ratio, 1.16; 95% CI, 1.07,1.26, respectively) than at tertiary hospitals. For women who were delivered at ≥37 weeks of gestation, cesarean delivery rates were 38.0%, 33.7%, and 30.0% for primary, secondary, and tertiary hospitals, respectively. Dysfunctional labor, cephalopelvic disproportion, and fetal distress were more commonly noted at primary and secondary hospitals (P<.001).
Conclusion |
Levels of expertise and staffing at tertiary hospitals may allow greater attempts and success with vaginal delivery among women with preeclampsia compared with primary or secondary hospitals.
Le texte complet de cet article est disponible en PDF.Keywords : Preeclampsia, cesarean delivery rates, tertiary care
Plan
 | Presented at the Twenty-Third Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, Calif, February 38, 2003. Reprint requests: Reprints will not be available from the authors. |
Vol 189 - N° 3
P. 824-829 - septembre 2003 Retour au numéro
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