| June data reports have gone out |
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 Thanks to all for your patience as we completed June data reports. We were not able to release them sooner because the report contains "aggregate" rates which are supposed to represent the rates of all hospitals participating in the initiative. We held off until almost all hospitals had completed their June data entry so that the aggregate rates would be accurate. At this time, three facilities have not submitted complete June data, but we do not anticipate significant changes in the aggregate rates, and we will share the complete June data during the August webinar. Please remember that fluctuations in the rates at an individual facility from one month to the next may be due to random variation, so it is important to look at the overall trend across many months when analyzing the data for your hospital.
The good news is that there appears to be another decrease in the "Joint Commission" rate for the month of June. This number represents the percentage of nulliparous women at term with a singleton, vertex fetus (with no exclusions for contraindications to vaginal delivery) with a cesarean delivery. The baseline aggregate rate (October/November 2010) was 26.84%. We've seen a fairly steady decline since March, and in June the percentage of women in this population delivered by c-section was 23.34%!
July data should be submitted by the end of next week.
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Does using Pitocin to shorten labor help women with prolonged first stage avoid a c-section?
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 A Cochrane Review published in July looked at eight randomized trials that studied the use of oxytocin and its role in cesarean delivery, comparing oxytocin to placebo/no treatment and comparing early vs. delayed use of oxytocin. The paper examined the hypothesis that oxytocin use may decrease the risk of a c-section in women with slow progress in the first stage of labor; slow progress is associated with an increased risk of c-section and of maternal and neonatal morbidity.
The authors found that there were no differences among these groups in the rate of c-section or instrumental vaginal delivery. Patient with early use of oxytocin had an increased rate of uterine hyperstimulation with fetal heart changes. However, there were no significant differences in maternal and neonatal outcomes in this group. Early use of oxytocin was associated with a decrease in the mean duration of labor of 2 hours but not with an increased rate of vaginal delivery. To review a copy of the full paper, click here.
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| August webinar |
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The August webinar will be held on Tuesday August 23, 7:30-9:00am. Please make sure your team members have this date on their calendars.
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Contact Kate
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Kate Berrien, RN, BSN, MS
UNC Center for Maternal & Infant Health
CB# 7181
Chapel Hill, NC 27599
kberrien@unch.unc.edu
Phone: 919-843-9336 Fax: 919-843-7866 |
