Next Article in Journal
Effects of Combined Remote Ischemic Pre-and Post-Conditioning on Neurologic Complications in Moyamoya Disease Patients Undergoing Superficial Temporal Artery-Middle Cerebral Artery Anastomosis
Previous Article in Journal
Early Identification of Isolated Sertoli Cell Dysfunction in Prepubertal and Transition Age: Is It Time?
Article Menu

Export Article

Open AccessArticle

Variability of Clinical Practice in the Third Stage of Labour in Spain

1
Department of Obstetrics & Gynaecology, Alcázar de San Juan, 13600 Ciudad Real, Spain
2
Department of Sociology, Social Work and Public Health, University of Huelva, 21071 Huelva, Spain
3
Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 091650, Ecuador
4
Department of Nursing, Ciudad Real Nursing School. University of Castilla-La Mancha, 13071 Ciudad Real, Spain
5
Department of Nursing, University of Jaen, 23071 Jaen, Spain
6
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(5), 637; https://doi.org/10.3390/jcm8050637
Received: 12 April 2019 / Revised: 6 May 2019 / Accepted: 7 May 2019 / Published: 9 May 2019
(This article belongs to the Section Obstetrics & Gynecology)
  |  
PDF [256 KB, uploaded 9 May 2019]

Abstract

Clinical practice guidelines recommend the active management of the third stage of labour, but it is currently unknown what practices professionals actually perform. Therefore, the aim of this study was to determine the variability of professional practices in the management of the third stage of labour and to identify any associated professional and work environment factors. A nationwide cross-sectional study was performed with 1054 obstetrics professionals between September and November 2018 in Spain. A self-designed questionnaire was administered online. The crude odds ratios (OR) and adjusted odds ratios (ORa) were estimated using binary logistic regression. The main outcome measures were included in the clinical management of the third stage of labour and they were: type of management, drugs, doses, routes of administration, and waiting times used. The results showed that 75.3% (783) of the professionals used uterotonic agents for delivery. Oxytocin was the most commonly administered drug. Professionals who attend home births were less likely to use uterotonics (ORa: 0.23; 95% confidence interval (CI): 0.12–0.47), while those who completed their training after 2007 (ORa: 1.57 (95% CI: 1.13–2.18) and worked in a hospital that attended >4000 births per year (ORa: 7.95 CI: 4.02–15.72) were more likely to use them. Statistically significant differences were also observed between midwives and gynaecologists as for the clinical management of this stage of labour (p < 0.005). These findings could suggest that there is clinical variability among obstetrics professionals regarding the management of delivery. Part of this variability can be attributed to professional and work environment factors. View Full-Text
Keywords: manual removal of placenta; professional practice; postpartum haemorrhage; third stage of labour; uterotonic agents; patient safety; quality improvement manual removal of placenta; professional practice; postpartum haemorrhage; third stage of labour; uterotonic agents; patient safety; quality improvement
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Ortiz-Esquinas, I.; Gómez-Salgado, J.; Pascual-Pedreño, A.I.; Rodríguez-Almagro, J.; Martínez-Galiano, J.M.; Hernández-Martínez, A. Variability of Clinical Practice in the Third Stage of Labour in Spain. J. Clin. Med. 2019, 8, 637.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top