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National variations in operative vaginal deliveries in Ireland
Author(s) -
Daly Niamh,
Bonham Sheelagh,
O'Dwyer Vicky,
O'Connor Clare,
Kent Etaoin,
Turner Michael J.
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.12.009
Subject(s) - medicine , obstetrics , gynecology , general surgery
Objective To compare the percentage of operative vaginal delivery (OVD) among all publicly funded maternity hospitals in Ireland and to develop quality control performance tables to facilitate national benchmarking. Methods The analysis included deliveries of neonates weighing 500 g or more in publicly funded hospitals in Ireland in 2010. Information was obtained from the Irish National Perinatal Reporting System. Maternities delivering in 1 private hospital or at home, and those with unknown parity were excluded. Mean ± SD OVD rates were calculated per hospital. Quality control tables were devised. Results In 2010, there were 75 600 deliveries, of which 73 029 met the inclusion criteria. The number of deliveries per hospital ranged from 1284 to 9759. The OVD rate per hospital was 15.3 ± 2.6% (range, 11.7–20.4%). The OVD rate was 29.1% among primigravidas (n = 30 468) compared with 6.7% among multigravidas (n = 42 561) ( P < 0.001). Using quality control tables, 52.6% (n = 10) and 31.6% (n = 6) of hospitals were more than 1 SD outside the national mean for forceps and ventouse delivery, respectively. Conclusion Wide variations were found in both the range of OVD and instrument choice among maternity hospitals in Ireland, raising questions about practice and training in contemporary obstetrics.