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Type: Journal article
Title: Intrapartum referral from primary to secondary care in the Netherlands: a retrospective cohort study on management of labor and outcomes
Author: Perdok, H.
Jans, S.
Verhoeven, C.
van Dillen, J.
Mol, B.
de Jonge, A.
Citation: Birth: Issues in Perinatal Care, 2015; 42(2):156-164
Publisher: Wiley
Issue Date: 2015
ISSN: 0730-7659
Statement of
Hilde Perdok, Suze Jans, Corine Verhoeven, Jeroen van Dillen, Ben Willem Mol, and Ank de Jonge
Abstract: BACKGROUND: In the Dutch maternity care system, primary care midwives provide care to low-risk women and refer to obstetricians if risks or complications occur. We examined reasons for referral, management of labor, and maternal and neonatal outcomes among women who were referred during labor. METHODS: In a retrospective cohort study, descriptive analyses were performed on data obtained from patient records. Six purposively chosen hospitals in The Netherlands participated in the study from June 2011 to February 2012. The study population included 600 pregnant women who were referred during labor from primary to secondary care. MAIN OUTCOME MEASURES: Reasons for referral, interventions after referral, mode of delivery, and maternal and neonatal outcomes. RESULTS: Of women who were referred during labor, three out of four women were referred for moderate risk indications: request for pain relief (30.5%), meconium-stained liquor (25.3%), failure to progress during first stage of labor (14.0%), and prolonged ruptured membranes without contractions (12.5%). Of all women, 65.7 percent had a spontaneous vaginal delivery and 59.7 percent received some kind of pain relief. Acute referral, meaning fetal distress, occurred in 5.5 percent. Of the newborns, 2.7 percent had an Apgar score of 7 or less after 5 minutes and 1.2 percent had an umbilical cord pH < 7.05. Postpartum complications occurred among 11.0 percent of women. CONCLUSION: Women who are referred during labor have a high probability of spontaneous vaginal delivery. To improve continuity of care and satisfaction for this group of women, management of labor could be continued by trained primary care midwives.
Keywords: care during labor; midwifery; obstetrics; referrals
Description: Article first published online: 6 APR 2015
Rights: © 2015 Wiley Periodicals, Inc.
DOI: 10.1111/birt.12160
Appears in Collections:Aurora harvest 7
Obstetrics and Gynaecology publications

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