British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Mar 1983
Selection of an obstetric data base for a microcomputer and its use for on-line production of birth notification forms, discharge summaries and perinatal audit.
A microcomputer system is described which stores data for perinatal audit and produces 'on-line' the statutory birth notification form and mother and baby discharge summary. The derivation of a minimum data-base and the methods used to obtain reliable data are outlined. ⋯ A study of the accuracy of the handwritten birth notification forms revealed a high error rate which was markedly reduced by the use of the microcomputer system. The system is now in routine use and further developments are outlined.
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The effect of epidural analgesia on oxytocin release during the second stage of normal labour was studied by comparing 10 primigravidae who had epidurals with 10 control subjects who did not have epidurals. A significant increment in oxytocin between paired peripheral blood samples taken at the onset of full cervical dilatation and crowning of the fetal head was found in the control subjects but not in those with epidurals. Forceps delivery was required more often in the group with epidural analgesia and was associated with lower oxytocin levels at crowning. Since distension of the lower birth canal and stimulation of pelvic autonomic nerves leads to oxytocin release, and the need for forceps associated with epidurals can be reduced by oxytocin, these differences are attributed to the lumbar epidural block.