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How does the mode of delivery affect the cost of maternity care?
Int J Gynecol Obstet,
67
1992, 38: 67-74
International Federation of Gynecology and Obstetrics
Citations from the Literature Thisis a selection of abstracts from the literature in the field of obstetrics and gynecology which the Journal’s Editors feel may be of interest to our readers* PREGNANCY AND DELIVERY !3exoal assaultin pregnancy Satin AJ; Hemsell DL; Stone IC Jr; Theriot S; Wendel GD Jr Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas. TX 75235-9032. USA
OBSTET GYNECOL 1991 77/5 (710-714) Little is known about the acute effects of sexual assault on pregnant victims and the outcome of their gestations. A retrospective review of sexual assault victims in Dallas County from 1983-1988 revealed that 114 of 5734 (2%) were pregnant. There were 0.55 and 0.75 gravid sexual assault victims per 1000 deliveries for Dallas County and Parkland Memorial Hospital, respectively. The purposes of this study were to examine patient demographics, forensic evidence, and patterns of injury in pregnant victims compared with 114 matched nonpregnant sexual assault victims, and to compare pregnancy outcome with that of the Parkland Memorial Hospital obstetric population. The typical victim was a black, parous gravida in her twenties at a mean gestational age of 15 weeks, without previous prenatal care. Vulvar (95%), oral (27%), and anal (6%) penetration were reported with similar frequency in both groups. The detection of whole and motile sperm from the vaginal specimens was similar in pregnant and nonpregnant women. Physical trauma was more common in nonpregnant victims (63 versus 43%, P < .004), especially genital trauma (21 versus 5%; P < ,001). Injury was more common to the head and neck or extremities than in the abdomen, chest, or back in both groups. There was no difference in the pattern of trauma by gestational age, but there were no truncal injuries in women at 20 weeks gestation or greater. There were no spontaneous abortions or deliveries within 4 weeks of the assault, but low birth weight delivery (24%) and preterm delivery (16%) were common. Sexual assault during pregnancy is accompanied by less physical trauma than in non-pregnancy and has little immediate effect on pregnancy outcome. How does the mode of delivery affect the cost of maternity care?
Clark L; Mugford M; Paterson C National Perinatal Epidemiology ford OX2 6HE, GBR
Unit, Radckyfe Infirmary,
Ox-
BR J OBSTET GYNAECOL 1991 98/6 (519-523) In this paper we present estimates of the difference in the cost *Generated from the Excerpta Medica Database, EMBASE.
of hospital care for women having different modes of singleton delivery. The estimates are based on observation of resources used in different procedures, and on data from the North West Thames Region Maternity Information System. For vaginal delivery the average cost is f363, but could fall between f 189 and f773, and for caesarean section the average cost is f 1123, with a likely range from f837 to f 1560. The wide ranges in the costs of the two modes of delivery reflect variation in the length of stay and in the intensity of care required. The average cost for intrapartum care and postnatal stay is estimated to be f451 for all singleton births. Variation in operative delivery rates between hospitals implies differences in the overall cost of care at different maternity units. This partly reflects differences in the needs of the population served by the units, but also differences in clinical practice. It is important for decision makers to consider the balance between the costs and outcomes of different policies of care. Prevention of fetal growth retardation with low-dose aspirin: Figs of the EPREDA trial
Uzan S; Beausfils M; Breart G; Bazin B; Capitant C; Paris J Service de Medecine Interne A. Hopital Chine, 75020 Paris, FRA
Tenon, 4 Rue de la
LANCET 1991 337/8755 (1427-1431) The efficacy of low-dose aspirin in preventing fetal growth retardation was tested in a randomised, placebo-controlled, double-blind trial. A secondary aim was to find out whether dipyridamole improves the efficacy of aspirin, 323 women at 15-18 weeks amenorrhoea were selected at twenty-five participating centres on the basis of fetal growth retardation and/or fetal death or abruptio placentae in at least one previous pregnancy. They were randomly allocated to groups receiving placebo, 150 mg/day aspirin, or 150 mg/day aspirin plus 225 mg/day dipyridamole, for the remainder of the pregnancy. In the first phase of the trial all actively treated patients (n = 156) were compared with the placebo group (n = 73). Mean birthweight was significantly higher in the treated than in the placebo group (2751 [SD 6701 vs. 2526 [848] g; difference 225 g [95% CI 129-321 g], p = 0.029) and the frequency of fetal growth retardation in the placebo group was twice that in the treated group (19 [26%] vs. 20 [13%]; P < 0.02). The frequencies of stillbirth (4 [5%] vs. 2 [l%]) and abruptio placentae (6 [8%] vs 7 [So/]) were also higher in the placebo than in the treated group. The benefits of aspirin treatment were greater in patients with two or more previous poor outcomes than in those with only one. In the second analysis, of aspirin only Int J Gynecol Obstet 38
67
1992, 38: 67-74
International Federation of Gynecology and Obstetrics
Citations from the Literature Thisis a selection of abstracts from the literature in the field of obstetrics and gynecology which the Journal’s Editors feel may be of interest to our readers* PREGNANCY AND DELIVERY !3exoal assaultin pregnancy Satin AJ; Hemsell DL; Stone IC Jr; Theriot S; Wendel GD Jr Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas. TX 75235-9032. USA
OBSTET GYNECOL 1991 77/5 (710-714) Little is known about the acute effects of sexual assault on pregnant victims and the outcome of their gestations. A retrospective review of sexual assault victims in Dallas County from 1983-1988 revealed that 114 of 5734 (2%) were pregnant. There were 0.55 and 0.75 gravid sexual assault victims per 1000 deliveries for Dallas County and Parkland Memorial Hospital, respectively. The purposes of this study were to examine patient demographics, forensic evidence, and patterns of injury in pregnant victims compared with 114 matched nonpregnant sexual assault victims, and to compare pregnancy outcome with that of the Parkland Memorial Hospital obstetric population. The typical victim was a black, parous gravida in her twenties at a mean gestational age of 15 weeks, without previous prenatal care. Vulvar (95%), oral (27%), and anal (6%) penetration were reported with similar frequency in both groups. The detection of whole and motile sperm from the vaginal specimens was similar in pregnant and nonpregnant women. Physical trauma was more common in nonpregnant victims (63 versus 43%, P < .004), especially genital trauma (21 versus 5%; P < ,001). Injury was more common to the head and neck or extremities than in the abdomen, chest, or back in both groups. There was no difference in the pattern of trauma by gestational age, but there were no truncal injuries in women at 20 weeks gestation or greater. There were no spontaneous abortions or deliveries within 4 weeks of the assault, but low birth weight delivery (24%) and preterm delivery (16%) were common. Sexual assault during pregnancy is accompanied by less physical trauma than in non-pregnancy and has little immediate effect on pregnancy outcome. How does the mode of delivery affect the cost of maternity care?
Clark L; Mugford M; Paterson C National Perinatal Epidemiology ford OX2 6HE, GBR
Unit, Radckyfe Infirmary,
Ox-
BR J OBSTET GYNAECOL 1991 98/6 (519-523) In this paper we present estimates of the difference in the cost *Generated from the Excerpta Medica Database, EMBASE.
of hospital care for women having different modes of singleton delivery. The estimates are based on observation of resources used in different procedures, and on data from the North West Thames Region Maternity Information System. For vaginal delivery the average cost is f363, but could fall between f 189 and f773, and for caesarean section the average cost is f 1123, with a likely range from f837 to f 1560. The wide ranges in the costs of the two modes of delivery reflect variation in the length of stay and in the intensity of care required. The average cost for intrapartum care and postnatal stay is estimated to be f451 for all singleton births. Variation in operative delivery rates between hospitals implies differences in the overall cost of care at different maternity units. This partly reflects differences in the needs of the population served by the units, but also differences in clinical practice. It is important for decision makers to consider the balance between the costs and outcomes of different policies of care. Prevention of fetal growth retardation with low-dose aspirin: Figs of the EPREDA trial
Uzan S; Beausfils M; Breart G; Bazin B; Capitant C; Paris J Service de Medecine Interne A. Hopital Chine, 75020 Paris, FRA
Tenon, 4 Rue de la
LANCET 1991 337/8755 (1427-1431) The efficacy of low-dose aspirin in preventing fetal growth retardation was tested in a randomised, placebo-controlled, double-blind trial. A secondary aim was to find out whether dipyridamole improves the efficacy of aspirin, 323 women at 15-18 weeks amenorrhoea were selected at twenty-five participating centres on the basis of fetal growth retardation and/or fetal death or abruptio placentae in at least one previous pregnancy. They were randomly allocated to groups receiving placebo, 150 mg/day aspirin, or 150 mg/day aspirin plus 225 mg/day dipyridamole, for the remainder of the pregnancy. In the first phase of the trial all actively treated patients (n = 156) were compared with the placebo group (n = 73). Mean birthweight was significantly higher in the treated than in the placebo group (2751 [SD 6701 vs. 2526 [848] g; difference 225 g [95% CI 129-321 g], p = 0.029) and the frequency of fetal growth retardation in the placebo group was twice that in the treated group (19 [26%] vs. 20 [13%]; P < 0.02). The frequencies of stillbirth (4 [5%] vs. 2 [l%]) and abruptio placentae (6 [8%] vs 7 [So/]) were also higher in the placebo than in the treated group. The benefits of aspirin treatment were greater in patients with two or more previous poor outcomes than in those with only one. In the second analysis, of aspirin only Int J Gynecol Obstet 38