Each participating hospital received a detailed report this month based on data they submitted on scheduled deliveries <39 weeks from January to March 2010. Six months into the 39 Weeks Project, the data reflects an ongoing decline in elective deliveries <39 weeks, with a more marked decline in repeat low-transverse c-sections (without additional medical indication) compared to the first quarter of this project. For those deliveries <39 weeks with medical indication, an increasing percentage of those deliveries had objective evidence in the chart supporting the indication for delivery. It also appears that more hospitals are documenting a Bishop Score prior to initiation of an induction of labor, compared to the first quarter.
On the monthly call this month, criteria for establishing gestational age were reviewed. The "gold standard" for establishing or confirming the EDC is an ultrasound before 20 weeks. Some hospitals are asking both for gestational age and for the criteria used to determine that gestational age when scheduling an induction or repeat c-section that is not medically indicated. Concerns were raised about cases in which a gestational age may have been adjusted later in pregnancy. Many hospitals are now documenting the indication for a planned delivery <39 weeks at the time the delivery is scheduled. Some hospitals have done outreach to the providers who deliver at their facility so that practices will have all needed information when calling the hospital to schedule an induction or c-section.
On the monthly call this month, criteria for establishing gestational age were reviewed. The "gold standard" for establishing or confirming the EDC is an ultrasound before 20 weeks. Some hospitals are asking both for gestational age and for the criteria used to determine that gestational age when scheduling an induction or repeat c-section that is not medically indicated. Concerns were raised about cases in which a gestational age may have been adjusted later in pregnancy. Many hospitals are now documenting the indication for a planned delivery <39 weeks at the time the delivery is scheduled. Some hospitals have done outreach to the providers who deliver at their facility so that practices will have all needed information when calling the hospital to schedule an induction or c-section.
