1. RESULTS
The Impact of the Antenatal Booking Visit on the Mode of Delivery
Prof Yves Muscat Baron, Dr Ramona Camilleri, Dr Igor Knaeyzev,
Dr Katya Vella, Dr Naema Gherbal, Dr Miriam Gatt
Institution: Department of Obstetrics and Gynaecology, Mater Dei Hospital, Malta
Methods
Group 2
From 1/5/2012, the management of pregnancy and delivery was not only discussed verbally with the women but the steps of the whole process were documented on the co-operation card and hospital notes.
Group 1
During the period of May 2010 and April 2012 booking visits involved verbal counselling as to the management of pregnancy and delivery. In cases of previous Caesarean section, the mode of delivery was discussed at 36 weeks gestation.
Moreover, the women were informed of the appropriate date of induction so as to prepare them to await spontaneous onset of labour. In the majority, a gestation of 41+3 weeks was advocated.
In women with previous caesarean sections, unless contraindicated vaginal birth was encouraged at the booking visit. Spontaneous vaginal delivery was encouraged in all women where considered safe.
RESULTS
Group 1
May 2010 till April 2012
Group 2
May 2012 till May 2015
P value
No. of Deliveries
681
686
p=N.S.
Booking visit
15 weeks
17 weeks
p< 0.05
Induction rate
24.6%
28.2%
p=N.S
Caesarean Section
28.8%
27.4%.
Emergency Caesarean section
17.62%
14.72%.
Successful VBAC
18.7%
23.4%
CONCLUSION
Non-significant declining trends of Caesarean Sections and increased rates of vaginal birth after Caesarean section were noted, despite an increase in Induction rates, when comparing both periods under study.
Proper documented counselling at 17 weeks gestation gives timely direction to both pregnant mother and partner, allowing adequate time for preparation.
Moreover, direction of the management of pregnancy and delivery is given to junior personnel of both the Firm concerned and other staff members of the Department, who encounter this patient on the delivery suite.