Effects of algorithm for diagnosis of active labour: Cluster randomised trial
Authors: Cheyne, H., Hundley, V., Dowding, D., Bland, J.M., McNamee, P., Greer, I., Styles, M., Barnett, C.A., Scotland, G. and Niven, C.
Journal: BMJ
Volume: 337
Issue: 7683
Pages: 1396-1400
eISSN: 1756-1833
ISSN: 0959-8146
DOI: 10.1136/bmj.a2396
Abstract:Objective: To compare the effectiveness of an algorithm for diagnosis of active labour in primiparous women with standard care in terms of maternal and neonatal outcomes. Design: Cluster randomised trial. Setting: Maternity units in Scotland with at least 800 annual births. Participants: 4503 women giving birth for the first time, in 14 maternity units. Seven experimental clusters collected data from a baseline sample of 1029 women and a post-implementation sample of 896 women. The seven control clusters had a baseline sample of 1291 women and a post-implementation sample of 1287 women. Intervention: Use of an algorithm by midwives to assist their diagnosis of active labour, compared with standard care. Main outcomes: Primary outcome: use of oxytocin for augmentation of labour. Secondary outcomes: medical interventions in labour, admission management, and birth outcome. Results: No significant difference was found between groups in percentage use of oxytocin for augmentation of labour (experimental minus control, differences=0.3, 95% confidence interval -9.2 to 9.8; P=0.9) or in the use of medical interventions in labour. Women in the algorithm group were more likely to be discharged from the labour suite after their first labour assessment (difference= -19.2, -29.9 to -8.6; P=0.002) and to have more pre-labour admissions (0.29, 0.04 to 0.55; P=0.03). Conclusions: Use of an algorithm to assist midwives with the diagnosis of active labour in primiparous women did not result in a reduction in oxytocin use or in medical intervention in spontaneous labour. Significantly more women in the experimental group were discharged home after their first labour ward assessment. Trial registration: Current Controlled Trials ISRCTN00522952.
Source: Scopus
Effects of algorithm for diagnosis of active labour: cluster randomised trial.
Authors: Cheyne, H., Hundley, V., Dowding, D., Bland, J.M., McNamee, P., Greer, I., Styles, M., Barnett, C.A., Scotland, G. and Niven, C.
Journal: BMJ
Volume: 337
Pages: a2396
eISSN: 1756-1833
DOI: 10.1136/bmj.a2396
Abstract:OBJECTIVE: To compare the effectiveness of an algorithm for diagnosis of active labour in primiparous women with standard care in terms of maternal and neonatal outcomes. DESIGN: Cluster randomised trial. SETTING: Maternity units in Scotland with at least 800 annual births. PARTICIPANTS: 4503 women giving birth for the first time, in 14 maternity units. Seven experimental clusters collected data from a baseline sample of 1029 women and a post-implementation sample of 896 women. The seven control clusters had a baseline sample of 1291 women and a post-implementation sample of 1287 women. INTERVENTION: Use of an algorithm by midwives to assist their diagnosis of active labour, compared with standard care. Main outcomes Primary outcome: use of oxytocin for augmentation of labour. SECONDARY OUTCOMES: medical interventions in labour, admission management, and birth outcome. RESULTS: No significant difference was found between groups in percentage use of oxytocin for augmentation of labour (experimental minus control, difference=0.3, 95% confidence interval -9.2 to 9.8; P=0.9) or in the use of medical interventions in labour. Women in the algorithm group were more likely to be discharged from the labour suite after their first labour assessment (difference=-19.2, -29.9 to -8.6; P=0.002) and to have more pre-labour admissions (0.29, 0.04 to 0.55; P=0.03). CONCLUSIONS: Use of an algorithm to assist midwives with the diagnosis of active labour in primiparous women did not result in a reduction in oxytocin use or in medical intervention in spontaneous labour. Significantly more women in the experimental group were discharged home after their first labour ward assessment. TRIAL REGISTRATION: Current Controlled Trials ISRCTN00522952.
Source: PubMed
Effects of algorithm for diagnosis of active labour: cluster randomised trial
Authors: Cheyne, H., Hundley, V., Dowding, D., Bland, J.M., McNamee, P., Greer, I., Styles, M., Barnett, C.A., Scotland, G. and Niven, C.
Journal: BMJ-BRITISH MEDICAL JOURNAL
Volume: 337
ISSN: 1756-1833
DOI: 10.1136/bmj.a2396
Source: Web of Science (Lite)
Effects of algorithm for diagnosis of active labour: cluster randomised trial
Authors: Cheyne, H., Hundley, V., Dowding, D., Bland, J.M., McNamee, P., Greer, I., Styles, M., Barnett, C.A., Scotland, G.S. and Niven, C.
Journal: British Medical Journal
Volume: 337
Pages: a2396
ISSN: 0959-8146
DOI: 10.1136/bmj.a2396
Abstract:Objective To compare the effectiveness of an algorithm for diagnosis of active labour in primiparous women with standard care in terms of maternal and neonatal outcomes.
Design Cluster randomised trial.
Setting Maternity units in Scotland with at least 800 annual births.
Participants 4503 women giving birth for the first time, in 14 maternity units. Seven experimental clusters collected data from a baseline sample of 1029 women and a post-implementation sample of 896 women. The seven control clusters had a baseline sample of 1291 women and a post-implementation sample of 1287 women.
Intervention Use of an algorithm by midwives to assist their diagnosis of active labour, compared with standard care.
Main outcomes Primary outcome: use of oxytocin for augmentation of labour. Secondary outcomes: medical interventions in labour, admission management, and birth outcome.
Results No significant difference was found between groups in percentage use of oxytocin for augmentation of labour (experimental minus control, difference=0.3, 95% confidence interval −9.2 to 9.8; P=0.9) or in the use of medical interventions in labour. Women in the algorithm group were more likely to be discharged from the labour suite after their first labour assessment (difference=−19.2, −29.9 to −8.6; P=0.002) and to have more pre-labour admissions (0.29, 0.04 to 0.55; P=0.03).
Conclusions Use of an algorithm to assist midwives with the diagnosis of active labour in primiparous women did not result in a reduction in oxytocin use or in medical intervention in spontaneous labour. Significantly more women in the experimental group were discharged home after their first labour ward assessment.
http://dx.doi.org/10.1136/bmj.a2396
Source: Manual
Preferred by: Vanora Hundley
Effects of algorithm for diagnosis of active labour: cluster randomised trial.
Authors: Cheyne, H., Hundley, V., Dowding, D., Bland, J.M., McNamee, P., Greer, I., Styles, M., Barnett, C.A., Scotland, G. and Niven, C.
Journal: BMJ (Clinical research ed.)
Volume: 337
Pages: a2396
eISSN: 1756-1833
ISSN: 0959-8138
DOI: 10.1136/bmj.a2396
Abstract:Objective
To compare the effectiveness of an algorithm for diagnosis of active labour in primiparous women with standard care in terms of maternal and neonatal outcomes.Design
Cluster randomised trial.Setting
Maternity units in Scotland with at least 800 annual births.Participants
4503 women giving birth for the first time, in 14 maternity units. Seven experimental clusters collected data from a baseline sample of 1029 women and a post-implementation sample of 896 women. The seven control clusters had a baseline sample of 1291 women and a post-implementation sample of 1287 women.Intervention
Use of an algorithm by midwives to assist their diagnosis of active labour, compared with standard care. Main outcomes Primary outcome: use of oxytocin for augmentation of labour.Secondary outcomes
medical interventions in labour, admission management, and birth outcome.Results
No significant difference was found between groups in percentage use of oxytocin for augmentation of labour (experimental minus control, difference=0.3, 95% confidence interval -9.2 to 9.8; P=0.9) or in the use of medical interventions in labour. Women in the algorithm group were more likely to be discharged from the labour suite after their first labour assessment (difference=-19.2, -29.9 to -8.6; P=0.002) and to have more pre-labour admissions (0.29, 0.04 to 0.55; P=0.03).Conclusions
Use of an algorithm to assist midwives with the diagnosis of active labour in primiparous women did not result in a reduction in oxytocin use or in medical intervention in spontaneous labour. Significantly more women in the experimental group were discharged home after their first labour ward assessment.Trial registration
Current Controlled Trials ISRCTN00522952.Source: Europe PubMed Central