Utilization of 17-Alpha-Hydroxyprogesterone Caproate in a Medicaid Population [16D]

Abstract

INTRODUCTION:A recently published expert opinion on interpretation and management of category II fetal heart tracings was adopted at our institution in 2014. Local Providers expressed concern that implementation of the algorithm may lead to an increase in the primary cesarean section rate for non-reassuring fetal heart tracings. METHODS: A retrospective chart review was performed to assess the potential effect of the algorithm on the cesarean section rate. Term Delivery records for pre and post implementation were reviewed. Inclusion criteria were singleton term pregnancies. Exclusion criteria were preterm pregnancies, multiple gestations, fetal anomalies, abnormal placentation, fetal malposition, uterine anomalies, prior uterine surgery, and other indications for cesarean delivery. Patient data included maternal demographics, obstetrical history and delivery outcomes. The primary outcome was the cesarean section rate. Secondary outcomes included NICU admissions, maternal and neonatal morbidity, and Apgar scores.