Resident consultant obstetrician presence on the labour ward versus other models of consultant cover: a systematic review of intrapartum outcomes
Background Several key policy documents have advocated 24‐hour consultant obstetrician presence on the labour ward as a means of improving the safety of birth. However, it is unclear what published evidence exists comparing the outcomes of intrapartum care with 24‐hour consultant labour ward presenc...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology Jg. 124; H. 9; S. 1311 - 1320 |
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| Hauptverfasser: | , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
England
Wiley Subscription Services, Inc
01.08.2017
John Wiley and Sons Inc |
| Schlagworte: | |
| ISSN: | 1470-0328, 1471-0528, 1471-0528 |
| Online-Zugang: | Volltext |
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| Zusammenfassung: | Background
Several key policy documents have advocated 24‐hour consultant obstetrician presence on the labour ward as a means of improving the safety of birth. However, it is unclear what published evidence exists comparing the outcomes of intrapartum care with 24‐hour consultant labour ward presence and other models of consultant cover.
Objectives
To collate and critically appraise evidence of the effect of continuous resident consultant obstetrician cover on the labour ward on outcomes of intrapartum care compared with other models of consultant cover.
Search strategy
Studies were included which quantitatively compared intrapartum outcomes for women and babies where continuous resident consultant obstetric cover was provided with other models of consultant cover.
Selection criteria
Quantitative studies within healthcare systems with mixed obstetric‐midwifery models of care.
Data collection and analysis
Two researchers independently screened titles and full‐text publications, extracted data and assessed the quality of included studies. Meta‐analysis was performed using REVIEW MANAGER 5.3.
Main results
About 1508 publications were screened resulting in two papers, three conference s and one letter being included. All were single‐site time‐period comparison studies. The quality of studies overall was poor with significant risk of bias. The only significant finding in meta‐analysis related to instrumental deliveries, which occurred more frequently when there was on‐call consultant cover (unadjusted risk ratio 1.14; 95% CI 1.04–1.24).
Conclusion
No reliable evidence of the effects of 24‐hour resident consultant presence on the labour ward on intrapartum outcomes was identified.
Tweetable
More robust research is needed to assess intrapartum outcomes with resident consultant labour ward presence.
Tweetable
More robust research is needed to assess intrapartum outcomes with resident consultant labour ward presence. |
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| Bibliographie: | ObjectType-Article-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Feature-3 ObjectType-Evidence Based Healthcare-1 ObjectType-Article-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 ObjectType-Undefined-4 Linked articles This article is commented on by WF Rayburn. To view this mini commentary visit https://doi.org/10.1111/1471-0528.14685. This article is also commented on by M Prior et al. To view this mini commentary visit https://doi.org/10.1111/1471-0528.14686. |
| ISSN: | 1470-0328 1471-0528 1471-0528 |
| DOI: | 10.1111/1471-0528.14527 |