Publications
2003
Labor augmentation in an Egyptian teaching hospital, The International Journal of Gynecology and Obstetrics, 2003; Vol. (85), Pp. 74-80.

Objectives: The study documented facility-based obstetric practices for normal labor in Egypt for the first time, to determine their relationship to evidence-based medicine. This paper describes the labor augmentation pattern observed. Methods: 176 cases of normal labor were observed by medically-trained observers using a checklist. Ward activities were also documented. Observed women were interviewed postpartum and all findings were shared with the providers for their feedback. Results: Labor was augmented in 91% (165) of the labors observed; this was inappropriate for 93% or 154 women. Reasons for inappropriateness were: oxygen ordered at the first vaginal exam (1%); in spite of intact membranes (36%), at the time of membrane rupture (42%), in spite of good progress (24%), or a combination of these. The monitoring of oxytocin-receiving women and their babies was inadequate. Conclusions: Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.
Author(s): Amr Elnoury , Hania Sholkamy , Karima Khalil , Miral Breebaart , Mohamed Cherine , Nevine Hassanein  
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