Publications (2)3.4 Total impact
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Article: The impact of length of second stage of labor on shoulder dystocia outcomes: a retrospective cohort study.
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ABSTRACT: To compare obstetrical and neonatal outcomes of vaginal deliveries complicated by shoulder dystocia, according to the length of second stage of labor. We conducted a retrospective cohort study of 177 shoulder dystocia cases that were divided into three categories according to second stage duration (1-20, 21-59, 60-180 min, respectively). The three categories were compared in terms of obstetric characteristics and neonatal outcomes. Statistical analysis utilized the χ2-test and analysis of variance where appropriate. The odds ratios of brachial plexus injury and having a 5-min APGAR score <7 across the second stage duration categories were calculated using logistic regression models that adjusted for potential confounders. The incidence of brachial plexus injury was 5.4% (1st category), 4.4% (2nd category) and 26.9% (3rd category); P<0.01. The higher incidence of brachial plexus injury in the group where second stage lasted >1 h was confirmed by logistic regression, with and without adjusting for confounders. The incidence of brachial plexus injury increases with the length of second stage, even after controlling for confounders.Journal of Perinatal Medicine 01/2012; 40(4):463-5. · 1.70 Impact Factor -
Article: Improved overall delivery documentation following implementation of a standardized shoulder dystocia delivery form.
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ABSTRACT: Our objective was to evaluate whether using a standardized shoulder dystocia delivery form improved documentation. A standardized delivery form was added to our institution's obstetrical record in August 2003. A retrospective cohort study was conducted comparing 100 vaginal deliveries complicated by shoulder dystocia before, and 81 after implementation of the standardized delivery form. The two groups were compared in terms of obstetric characteristics, neonatal outcomes and documentation components. Charts that included the standardized delivery form were more likely to contain documentation of estimated fetal weight (82.7% vs. 39.0% without the form, P<0.001) and head-to-shoulder delivery interval (76.5% vs. 15.0% without the form, P<0.001). Both groups were statistically similar in terms of documenting estimated blood loss and fetal weight, umbilical cord pH, type and order of maneuvers utilized to relieve the shoulder dystocia, and second stage duration. Inclusion of a standardized form in the delivery record improves the rate of documentation of both shoulder dystocia-specific and general delivery components.Journal of Perinatal Medicine 10/2011; 40(1):97-100. · 1.70 Impact Factor
