Comparison of neonatal outcomes and intrapartum events in full term vaginal deliveries conducted by staff versus resident physicians

OBJECTIVE: The objective of this study was to compare the neonatal outcomes and intrapartum events conducted by staff versus resident physicians in full term vaginal deliveries. METHODS: We divided study population (n = 5,007) into two groups: staff versus resident physicians. These two groups were sub-divided; faculty versus fellow and senior versus junior resident, respectively. The maternal characteristics, neonatal outcomes including Apgar score, admission to the neonatal intensive care unit and umbilical arterial pH and intrapartum event which was defined as the occurrence of shoulder dystocia and vacuum delivery were also investigated. RESULTS: There was no difference in neonatal outcomes between two groups. The group delivered by staff had a higher rate of nulliparity, large for gestational age and intrapartum events than the resident physician group. The subgroup analysis revealed a higher rate of vacuum delivery in the group delivered by faculty and senior members than the group delivered by fellows and junior members. CONCLUSION: There was no significant difference in neonatal outcomes between the two groups; staff versus resident physicians in full term vaginal deliveries in low-risk pregnant women. Also, experienced obstetricians might tend to participate in difficult labors and would prefer applying vacuum compared to the obstetricians with fewer experiences.

Effect of Labor Epidural Analgesia on Rates of Cesarean Section and Vacuum Delivery / 대한마취과학회지

BACKGROUND: This study was done to compare vacuum delivery and cesarean section rates in a large population before and after on-demand labor epidural analgesia became available. METHODS: We retrospectively investigated the overall sets of delivery modes in patients who gave birth during a 12-month period before the introduction of on-demand labor epidural analgesia, and those giving birth after labor epidural analgesia became available. Additionally, we compared the rates of cesarean section or vacuum delivery in patients delivering before and after the availability of on-demand labor epidural. RESULTS: Included were 3905 patients who delivered before, and 4318 patients who delivered after epidural analgesia became available. Labor epidural rates were 0.3% vs 14.7% for the before and after groups. The rates of cesarean delivery for dystocia in primary cesarean operation did not change (10% vs 10.5%), and vacuum delivery rates in the total vaginal delivery patients were not changed (15.1% vs 14.7%) for the before and after group. CONCLUSIONS: Increased epidural analgesia did not change the overall cesarean delivery rates for dystocia and vacuum - assisted delivery rates.