Influence of the birth attendant on maternal and neonatal outcomes during normal vaginal delivery: a comparison between midwife and physician management.

Abstract:

BACKGROUND:The purpose of this study was to compare the obstetric outcome of low-risk maternity patients attended by certified midwives with that of low-risk maternity patients attended by obstetricians. PATIENTS AND METHODS:Obstetric outcome of 1352 midwife patients was compared with that of 1352 age- and parity-matched physician patients with normal spontaneous vaginal delivery at the Department of Obstetrics and Gynecology of the University Hospital Vienna during the period from January 1997 to July 2002. Our analysis was restricted to a sample of low-risk pregnant women. Women with medical or obstetric risk factors were excluded. RESULTS:A significant decrease in the use of oxytocin (p=0.0001) was observed in women who selected a midwife as their primary birth attendant compared with women in the physician group. In both groups most women gave birth in a supine position; however, significantly more alternative birth positions were used by midwife patients (p = 0.0001). Concerning perineal trauma, a significantly lower rate of episiotomies (p = 0.0001) and perineal tears of all degrees (p=0.006) were found in midwife patients. When analyzing severe postpartum hemorrhage and postpartum infections, there were no significant differences between the two groups (p > 0.05). Concerning neonatal outcome, there were no significant differences in APGAR score < 7 at 5 minutes (p > 0.05). Our data clearly show the ability of certified midwives to successfully provide prenatal care and delivery to low-risk maternity patients, with neonatal outcomes comparable to those of physician patients. The use of certified midwives supervised by obstetricians may provide the optimum model for perinatal care, particularly for those women who are low-risk maternity patients, leaving physicians free to attend to the high-risk elements of care.

journal_name

Wien Klin Wochenschr

authors

Bodner-Adler B,Bodner K,Kimberger O,Lozanov P,Husslein P,Mayerhofer K

doi

10.1007/BF03040917

subject

Has Abstract

pub_date

2004-06-30 00:00:00

pages

379-84

issue

11-12

eissn

0043-5325

issn

1613-7671

journal_volume

116

pub_type

临床试验,杂志文章
  • CO2 insufflation during colonoscopy decreases post-interventional pain in deeply sedated patients: a randomized controlled trial.

    abstract:INTRODUCTION:Air insufflation during colonoscopy is considered the standard method in most endoscopic centers. Notably, several studies have reported reduced abdominal pain after colonoscopy with CO2 insufflation in unsedated and in lightly sedated patients. The present study was designed to assess the efficacy of CO2 ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00508-009-1202-y

    authors: Riss S,Akan B,Mikola B,Rieder E,Karner-Hanusch J,Dirlea D,Mittlböck M,Weiser FA

    更新日期:2009-01-01 00:00:00

  • [Botulinum toxin type A in the treatment plan for cerebral palsy].

    abstract::Over the past decade a number of placebo-controlled studies have confirmed that intramuscular injections of botulinum toxin A (BTX A) has antispastic effects. Cerebral palsy is among the most frequent disorders of the growing locomotor apparatus during childhood. Weakness as well as spasticity due to lack of selective...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:

    authors: Strobl W

    更新日期:2001-01-01 00:00:00

  • [Possibilities and limits of cytostatic chemotherapy in pancreatic carcinoma].

    abstract::The investigation of chemotherapy for pancreatic cancer has been hampered by the fact that most patients present with severe general illness and thus tolerate this form of treatment poorly. Furthermore, because of the relative inaccessibility of the pancreas it has been difficult to monitor objective response rates. I...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:

    authors: Scheithauer W

    更新日期:1994-01-01 00:00:00

  • Impaired anal sphincter function in professional cyclists.

    abstract:BACKGROUND:The purpose of our study was to assess anal function in professional mountain bikers, as an increasing number of cycling enthusiasts report functional and morphological problems in the anal region. We tried to find out if constant saddle vibration suffered by professional cyclists could lead to defecation di...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-006-0741-8

    authors: Sauper T,Lanthaler M,Biebl M,Weiss H,Nehoda H

    更新日期:2007-01-01 00:00:00

  • Clinical characteristics associated with bradycardia and asystole in patients with syncope undergoing long-term electrocardiographic monitoring with implantable loop recorder.

    abstract:BACKGROUND:The aim of this retrospective single center cohort study was to assess the occurrence of bradycardia during implantable loop recorder (ILR) monitoring in patients with unexplained syncope and negative conventional testing and to identify clinical predictors of bradycardia and pacemaker implantation. METHODS...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-017-1197-8

    authors: Mitro P,Šimurda M,Müller E

    更新日期:2017-07-01 00:00:00

  • [Clinical results with dopamine in acute renal failure (author's transl)].

    abstract::Dopamine possesses specific pharmacological actions which distinguish it from the other catecholamines. Apart from its positive inotropic effect, dopamine exerts a favourable influence on renal function with an increase in renal blood flow and alterations in intrarenal haemodynamics. The use of dopamine in the early s...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Pichler M,Kleinberger G,Kotzaurek R,Pall H,Szeless S

    更新日期:1976-01-23 00:00:00

  • [Pharmacology of DTIC (author's transl)].

    abstract::DTIC, a new cytostatic drug developed by the NCI-USA, is described and some relevant pharmacological characteristics are defined. This drug was proved to be the number one choice for the treatment of malignant melanoma and of sarcomas. It also appears to be of value in advanced cases of Hodgkins disease. DTIC represen...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:

    authors: Karrer K

    更新日期:1978-12-22 00:00:00

  • [Changes in serum lipoproteins in cerebrovascular disease (author's transl)].

    abstract::The determination of serum cholesterol, triglycerides and lipoprotein cholesterol (VLDL, LDL and HDL) in 96 patients suffering from cerebral vascular disease showed that some parameters were significantly different from those recorded in a control population of corresponding age HDL values below 40 mg/dl were found in...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Bruck J,Fischer M,Tschabitscher H

    更新日期:1981-10-16 00:00:00

  • [Pathophysiology and therapy of diabetic ketoacidosis and of non-ketoacidotic hyperosmolar diabetic coma].

    abstract::Metabolic derangements in diabetic coma are the sequelae of insulin deficiency. These defects are aggravated by the actions of insulin counteracting ("diabetogenic") hormones and hypertonic dehydration, which both impair insulin action. Conversely, it has been shown that hypo-osmolar rehydration of a hyperosmolar, sev...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:

    authors: Waldhäusl W,Kleinberger G,Bratusch-Marrain P,Komjati M

    更新日期:1984-04-27 00:00:00

  • Management and outcome of traumatic subdural hematoma in 47 infants and children from a single center.

    abstract:BACKGROUND:Traumatic brain injury (TBI) is a frequent cause of mortality and acquired neurological impairment in children. It is hypothesized, that with the adequate treatment of SDH in children and adolescence, excellent clinical and functional outcomes can be achieved. The aim of this study was to present the severit...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-020-01648-3

    authors: Binder H,Tiefenboeck TM,Majdan M,Komjati M,Schuster R,Hajdu S,Leitgeb J

    更新日期:2020-09-01 00:00:00

  • Bluetongue: Vector surveillance in Austria in 2007.

    abstract::Since the first outbreaks of bluetongue disease (BTD) were reported from The Netherlands, Germany, and Belgium in autumn of 2006, the disease is a main topic in Central Europe. The infectious disease, which originated in South Africa and from which Austria has been spared up to now, affects particularly sheep, cattle,...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-008-1073-7

    authors: Sehnal P,Schweiger S,Schindler M,Anderle F,Schneemann Y

    更新日期:2008-01-01 00:00:00

  • [Percutaneous endoscopic gastrostomy--a possibility for enteral feeding of patients with severe cerebral dysfunctions].

    abstract::Patients who are unable to be adequately nourished owing to cerebral dysfunction do not tolerate nasogastric tubes for enteral nutrition well. They are threatened by active or passive dislocation of the tube into the oesophagus with subsequent aspiration. Although these risks are minimized by percutaneous gastrostomy ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Peschl L,Zeilinger M,Munda W,Prem H,Schragel D

    更新日期:1988-05-13 00:00:00

  • [Monoclonal antibodies in virology].

    abstract::The application of hybridoma technology to the preparation of monoclonal antibodies has had a strong stimulatory effect on many areas of virological research. This development has expanded our knowledge with respect to antigenic variation among viruses and detailed analysis of complex antigenic structures of virus pro...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:

    authors: Heinz FX

    更新日期:1985-03-01 00:00:00

  • [Preliminary results of prostaglandin E1 therapy in peripheral obliterating arteriopathy].

    abstract::Prostaglandin E1 was given intraarterially to twenty persons with severe peripheral ischaemia at risk of requiring amputation of a limb for ischaemic ulcers or necrosis. All patients had received conventional therapy without success before PG E1 treatment. An average dose of 6.14 ng/kg/min of PG E1 was given intraarte...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Pilger E,Juan H

    更新日期:1983-04-15 00:00:00

  • [Resection of cervical glands in pelviscopic hysterectomy].

    abstract::A case of pelviscopic hysterectomy with uterine hyperflexion and cervical elongation is presented. In this case we were forced to extirpate the cervical fascia because of uterine hemorrhage by laparotomy after the cervical tissue punch had been performed. The histological findings were supravaginal cervical glands. Co...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Wierrani F,Huber M,Grin W,Grünberger W

    更新日期:1994-01-01 00:00:00

  • [A comparative study of the value of skin tests and radio-allergo-sorbent tests in inhalation allergies (author's transl)].

    abstract::Skin tests were performed and the specific IgE levels determined by means of the radio-allero-sorbent test (RAST) in fifty patients with allergic rhinitis/conjunctivitis and extrinsic bronchial asthma. An overall correlation between in vitro and in vivo diagnosis was found in 87% of cases. The results of this study in...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Ebner H,Kraft D

    更新日期:1975-10-17 00:00:00

  • [Cardiogenic shock].

    abstract::Cardiogenic shock (CS) is defined as end-organ hypoperfusion as the consequence of primary myocardial dysfunction. Among the diagnostic criteria are a systolic blood pressure < 90 mmHg, acute renal failure (oligoanuria), ischemic hepatitis, cyanosis and cold, clammy skin. Accepted hemodynamic cutoffs are a cardiac ind...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-020-01612-1

    authors: Zilberszac R,Heinz G

    更新日期:2020-06-01 00:00:00

  • Health, self-regulation of bodily signals and intelligence: review and hypothesis.

    abstract::Childhood IQ and adult morbidity and mortality are known to be linked even beyond socioeconomic variables. Yet, their interrelations are insufficiently understood. It has been suggested that bodily sensations play a fundamental role in health-related self-regulation and that intelligence can influence the information ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:10.1007/s00508-010-1481-3

    authors: Fazekas C,Leitner A,Pieringer W

    更新日期:2010-12-01 00:00:00

  • Thrombolytic therapy and its combination with transluminal catheter dilatation.

    abstract::The material for complete occlusion of an artery is predominantly thrombotic. The longer the occluded segment the worse are the results of PTA since the thrombotic material is not compressible. As long as this thrombotic material is not already organized, it can be lysed by thrombolytic therapy, and thus removed. Rema...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Hess H

    更新日期:1985-01-18 00:00:00

  • [Treatment of infertile couples--an interdisciplinary task (author's transl)].

    abstract::The results obtained by closest cooperation between gynaecologist and andrologist in the treatment of sterile marriages are reported. 127 couples were treated over a period of 20 months. Almost 100% of the males and 60% of the females were sub- or infertile. Treatment of both partners was meticulously coordinated in o...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Grünberger W,Schneider WH,Maier U,Stackl W,Lunglmayr G

    更新日期:1980-05-09 00:00:00

  • Ventricular tachycardia induced by abuse of ephedrine in a young healthy woman.

    abstract:INTRODUCTION:Ephedrine or ephedra herbal products have occasionally been used to enhance sports performance and energy or to aid weight loss. The most serious side effects are those on cardiovascular function, including acute myocardial infarction, severe hypertension, myocarditis and lethal cardiac arrhythmias. CASE ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-006-0655-5

    authors: Rakovec P,Kozak M,Sebestjen M

    更新日期:2006-09-01 00:00:00

  • [Operative treatment of prostatic adenoma (author's transl)].

    abstract::The indications for operative treatment of prostatic adenomas are outlined. The three operative techniques (suprapubic adenomectomy, resection and cryosurgery) should not be considered rival procedures, but complementary methods of therapy. The postoperative mortality dropped from 5.64% in the years 1957-1967 to 1.01%...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Haschek H

    更新日期:1978-03-17 00:00:00

  • [Detection of sex-chromosome anomalies in newborn infants (author's transl)].

    abstract::6084 consecutive newborn infants were screened for the purpose of evaluation of the X- and Y-chromatin in the cells of the buccal mucosa to detect sex-chromosome anomalies. An anomaly was discovered in 14 newborn infants (0.23%). Among 3184 male infants 8 cases of Klinefelter's syndrome, 2 cases of XYY syndrome and 1 ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Wagenbichler P,Golob E

    更新日期:1975-02-21 00:00:00

  • [On the topic of do not resuscitate (DNR) orders on intensive care units: an evaluation of the present status on intensive care units of the Innsbruck University clinics].

    abstract:INTRODUCTION:Intensive care physicians are frequently called upon to decide whether intensive care treatment is justified. Critically ill patients with a poor prognosis receive "Do Not Resuscitate (DNR) Orders", which entitles the physician in charge to withhold cardiopulmonary resuscitation in case of cardiac arrest. ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Fries D,Kofler A,Hackl J,Schwamberger H,Klingler A,Antretter V,Schobersberger W

    更新日期:1999-02-26 00:00:00

  • Current legal status of advance directives in the United States.

    abstract::Advance directive legislation has been in place throughout much of the United States for nearly 3 decades. The right to give an informed consent to or refusal of medical treatment has been recognized by state and federal courts, and that right has been determined to survive the loss of decisional capacity and may be e...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/BF03040929

    authors: Rich BA

    更新日期:2004-07-15 00:00:00

  • Effects of migration background on weight status and motor performance of preschool children.

    abstract:BACKGROUND:The motor performance of children and adolescents declines. We questioned whether there are differences of motor performance and weight status between preschool children with and without migration background. METHODS:A total of 1,063 4- to 5-year-old children were recruited from 41 kindergartens in Tyrol, A...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-013-0474-4

    authors: Greier K,Riechelmann H

    更新日期:2014-02-01 00:00:00

  • Factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children.

    abstract:BACKGROUND:The increasing prevalence of overweight and obesity among children is often associated with motor deficits. Motor performance among children partly depends on modifiable factors, for example, weight status, electronic media use, sports club participation, and on nonmodifiable factors, for example, sex, age, ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:10.1007/s00508-015-0887-3

    authors: Ruedl G,Greier K,Kirschner W,Kopp M

    更新日期:2016-01-01 00:00:00

  • [Partial gluing in extra-intracranial microvascular anastomoses (author's transl)].

    abstract::In an extensive series of experimental studies conducted on the common carotid artery in rats, a combined technique involving suture and gluing with human fibrin glue has been developed. In view of the good results achieved, this technique was then applied in 12 patients in whom anastomosis between the superficial tem...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Kletter G,Matras H,Dinges HP

    更新日期:1978-06-09 00:00:00

  • [Regulation of intracellular pH by Na+/H+ exchange in human lymphocytes].

    abstract::Spectrofluorimetry and the pH-sensitive fluorescent dye 2',7'-bis(carboxyethyl)-5(6)carboxyfluorescein (BCECF) was used to measure the intracellular pH (pHi) of suspended human lymphocytes. A linear relationship exists between pHi and the fluorescent spinal-ratio (I490nm/I435nm, emission 526 nm) between pH 6.5 and pH ...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章

    doi:

    authors: Weinlich M,Wenzl E,Starlinger M,Schiessel R

    更新日期:1989-05-26 00:00:00

  • Disturbances of thyroid function in the elderly.

    abstract::Disturbances of thyroid function occur more often in the elderly than in the young. This short review gives an up-to-date overview of this topic. After discussing the difference in epidemiology of thyroid dysfunction in elderly persons in areas with different iodine nutrient status, the physiologic age-induced changes...

    journal_title:Wiener klinische Wochenschrift

    pub_type: 杂志文章,评审

    doi:10.1007/s00508-005-0504-y

    authors: Weissel M

    更新日期:2006-02-01 00:00:00