Society for Maternal-Fetal Medicine: Statewide effort slashes number of early scheduled births

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Details of a statewide effort in Ohio were revealed at the SMFM conference that demonstrated the successful reduction in the number of scheduled near-term births without a medical or obstetric indication from 1 in 4 to less than 1 in 20.

Jay Iams, MD, for the Ohio Perinatal Quality Collaborative unveiled the details of a statewide effort in Ohio that successfully reduced the number of scheduled near-term births-either by cesarean delivery or induction of labor-without a medical or obstetric indication from 1 in 4 to less than 1 in 20 (P<0.05).

Using a variety of education and intervention tools, 20 level 2 and 3 maternity hospitals-which handle about half of the state's births-shared their methods during the 14-month study. As a result, the rate of scheduled births between 36.1 and 38.6 weeks without medical necessity declined from 25% to below 5%. Inductions without medical necessity also declined from a 12-month mean of 13% to 8% (P<.0027), and fewer infants born at 36 to 38 weeks' gestation were admitted to the neonatal intensive care unit.

The Ohio Perinatal Quality Collaborative; Iams J. A statewide initiative to reduce scheduled births without appropriate indication [abstract]. Am J Obstet Gynecol. 2009;201(6 suppl):S19. Abstract 33.

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