Immediate Versus Delayed Admission in Early Labor [A214]. (May 2022)

• Record Type: Journal Article
• Authors: Iovino, Nicole; Chappelle, Joseph
• Is Part Of: Obstetrics and gynecology. Volume 139(2022)Supplement 1
• Page Start: 62S
• Page End: 62S
• Publication Date: 2022-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000826132.06960.73
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: There is no clear consensus on when to admit patients in early labor. The purpose of this study is to evaluate whether early labor admission increases rate of cesarean delivery compared to delayed admission, and additionally, to explore differences in neonatal outcomes and length of hospital stay among these groups. METHODS: A retrospective cohort study comparing immediate versus delayed admission in full-term patients presenting in early labor at a university-based tertiary-care center and found to be 1–4 cm dilated. RESULTS: Of 432 patients who presented to our hospital for labor evaluation, 131 were admitted on initial presentation and 301 experienced delayed admission. There was no statistically significant difference in rate of cesarean delivery in the immediate admission group versus delayed admission (6.1% versus 10.3%, P =.2), Apgar<7 (5.3% versus 4.9%, P =.811), meconium (26% versus 28.1%, P =.377), infection (5.3% versus 49.7%, P =.41) or NICU admissions (11.5% versus 16.4%, P =.187). Time from admission to delivery was statistically similar among these groups (10.9 versus 12.5 h, P =177). CONCLUSION: There was no evidence of increased risk of cesarean delivery or harm in patients who underwent immediate admission. Interestingly, both patients who were admitted initially and those who had their admission delayed had similar lengths of time until to delivery once they were admitted, suggesting that providers likely have a good clinical sense of when a patient should be admitted, or at a minimum are consistent. There is no clear answer on optimal timing for admissions; thus we should continue to use clinical judgment, talk to our patients, and make joint decisions.