Labor augmentation in an Egyptian teaching hospital
Objectives: 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. Methods: 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. Results: 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. Conclusions: Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.
Khalil, Karima, Mohamed Cherine, Amr Elnoury, Hania Sholkamy, Miral Breebaart, and Nevine Hassanein. 2004. "Labor augmentation in an Egyptian teaching hospital," International Journal of Gynecology and Obstetrics 85(1): 74–80.