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Describing Prehospital Deliveries in the State of Michigan
IntroductionWe observed clinically that prehospital deliveries locally appeared to have a high rate of complications and appeared associated with midwife deliveries. There is scant literature that addresses prehospital deliveries across a state. We set out to describe utilization, complications, and...
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Published in: | Curēus (Palo Alto, CA) CA), 2022-07, Vol.14 (7), p.e26723-e26723 |
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description | IntroductionWe observed clinically that prehospital deliveries locally appeared to have a high rate of complications and appeared associated with midwife deliveries. There is scant literature that addresses prehospital deliveries across a state. We set out to describe utilization, complications, and short-term outcomes of EMS-attended prehospital deliveries in Michigan in 2015, and to describe the relationship between prehospital delivery and socioeconomic status (SES).MethodsWe identified candidate cases for prehospital deliveries through the Michigan EMS Information System (MI-EMSIS). To assess the relationship of SES with the frequency of EMS delivery, we utilized the mean income of the patient residences' zip codes.ResultsWe identified 223 EMS-attended deliveries from 1.6 million MI-EMSIS records. Most births were normal vaginal deliveries on the scene or en route to the hospital (92, 40.0%) or delivered prior to EMS arrival (58, 25.4%). Maternal or fetal complications were identified in 69 (32.0%) deliveries. We identified a few midwife-attended deliveries (31), but these had a high rate of complications (19, 61.3%). The frequency of prehospital delivery was inversely related to estimated patient income (Pearson=-0.85).ConclusionsEMS deliveries were rare and most were normal vaginal deliveries, but almost a third had complications. Midwife and EMS-attended deliveries were rare, but when they occurred, had high rates of complications. Although an imperfect measure of patient SES, frequency of delivery was inversely related to patient income, and agencies that provide care in these communities should have focused training. |
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There is scant literature that addresses prehospital deliveries across a state. We set out to describe utilization, complications, and short-term outcomes of EMS-attended prehospital deliveries in Michigan in 2015, and to describe the relationship between prehospital delivery and socioeconomic status (SES).MethodsWe identified candidate cases for prehospital deliveries through the Michigan EMS Information System (MI-EMSIS). To assess the relationship of SES with the frequency of EMS delivery, we utilized the mean income of the patient residences' zip codes.ResultsWe identified 223 EMS-attended deliveries from 1.6 million MI-EMSIS records. Most births were normal vaginal deliveries on the scene or en route to the hospital (92, 40.0%) or delivered prior to EMS arrival (58, 25.4%). Maternal or fetal complications were identified in 69 (32.0%) deliveries. We identified a few midwife-attended deliveries (31), but these had a high rate of complications (19, 61.3%). The frequency of prehospital delivery was inversely related to estimated patient income (Pearson=-0.85).ConclusionsEMS deliveries were rare and most were normal vaginal deliveries, but almost a third had complications. Midwife and EMS-attended deliveries were rare, but when they occurred, had high rates of complications. Although an imperfect measure of patient SES, frequency of delivery was inversely related to patient income, and agencies that provide care in these communities should have focused training.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.26723</identifier><identifier>PMID: 35967190</identifier><language>eng</language><publisher>Palo Alto: Cureus Inc</publisher><subject>Attended births ; Births ; Childbirth & labor ; Datasets ; Emergency medical care ; Emergency Medicine ; Emergency services ; Fetuses ; Hemorrhage ; Information systems ; Midwifery ; Obstetrics/Gynecology ; Prenatal care ; Socioeconomic factors ; Statistics ; Vagina</subject><ispartof>Curēus (Palo Alto, CA), 2022-07, Vol.14 (7), p.e26723-e26723</ispartof><rights>Copyright © 2022, Eisenbrey et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2022, Eisenbrey et al. 2022 Eisenbrey et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c319t-6d6de0942b06540ca211eed323d5b7b755a6da787c35d1a15c5357d0b7548e8e3</citedby><cites>FETCH-LOGICAL-c319t-6d6de0942b06540ca211eed323d5b7b755a6da787c35d1a15c5357d0b7548e8e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2708654571/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2708654571?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><creatorcontrib>Eisenbrey, David</creatorcontrib><creatorcontrib>Dunne, Robert B</creatorcontrib><creatorcontrib>Fales, William</creatorcontrib><creatorcontrib>Torossian, Kristopher</creatorcontrib><creatorcontrib>Swor, Robert</creatorcontrib><title>Describing Prehospital Deliveries in the State of Michigan</title><title>Curēus (Palo Alto, CA)</title><description>IntroductionWe observed clinically that prehospital deliveries locally appeared to have a high rate of complications and appeared associated with midwife deliveries. There is scant literature that addresses prehospital deliveries across a state. We set out to describe utilization, complications, and short-term outcomes of EMS-attended prehospital deliveries in Michigan in 2015, and to describe the relationship between prehospital delivery and socioeconomic status (SES).MethodsWe identified candidate cases for prehospital deliveries through the Michigan EMS Information System (MI-EMSIS). To assess the relationship of SES with the frequency of EMS delivery, we utilized the mean income of the patient residences' zip codes.ResultsWe identified 223 EMS-attended deliveries from 1.6 million MI-EMSIS records. Most births were normal vaginal deliveries on the scene or en route to the hospital (92, 40.0%) or delivered prior to EMS arrival (58, 25.4%). Maternal or fetal complications were identified in 69 (32.0%) deliveries. We identified a few midwife-attended deliveries (31), but these had a high rate of complications (19, 61.3%). The frequency of prehospital delivery was inversely related to estimated patient income (Pearson=-0.85).ConclusionsEMS deliveries were rare and most were normal vaginal deliveries, but almost a third had complications. Midwife and EMS-attended deliveries were rare, but when they occurred, had high rates of complications. Although an imperfect measure of patient SES, frequency of delivery was inversely related to patient income, and agencies that provide care in these communities should have focused training.</description><subject>Attended births</subject><subject>Births</subject><subject>Childbirth & labor</subject><subject>Datasets</subject><subject>Emergency medical care</subject><subject>Emergency Medicine</subject><subject>Emergency services</subject><subject>Fetuses</subject><subject>Hemorrhage</subject><subject>Information systems</subject><subject>Midwifery</subject><subject>Obstetrics/Gynecology</subject><subject>Prenatal care</subject><subject>Socioeconomic factors</subject><subject>Statistics</subject><subject>Vagina</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkUtLAzEUhYMottTu_AEDblw4NY_JJONCkNYXVBTUdcgkt23KdFKTmYL_3qktoq7uhfNx7j0chE4JHgnBi0vTBmjjiOaCsgPUpySXqSQyO_y199AwxiXGmGBBscDHqMd4kQtS4D66mkA0wZWunicvARY-rl2jq2QCldtAcBATVyfNApLXRjeQ-Fny5MzCzXV9go5muoow3M8Ber-7fRs_pNPn-8fxzTQ1jBRNmtvcAi4yWuKcZ9hoSgiAZZRZXopScK5zq4UUhnFLNOGGMy4s7pRMggQ2QNc733VbrsAaqJugK7UObqXDp_Laqb9K7RZq7jeqYHl3pegMzvcGwX-0EBu1ctFAVekafBsVFZhmknGJO_TsH7r0bai7eFtKdgG4IB11saNM8DEGmP08Q7Da9qJ2vajvXtgXDDZ_XQ</recordid><startdate>20220710</startdate><enddate>20220710</enddate><creator>Eisenbrey, David</creator><creator>Dunne, Robert B</creator><creator>Fales, William</creator><creator>Torossian, Kristopher</creator><creator>Swor, Robert</creator><general>Cureus Inc</general><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220710</creationdate><title>Describing Prehospital Deliveries in the State of Michigan</title><author>Eisenbrey, David ; Dunne, Robert B ; Fales, William ; Torossian, Kristopher ; Swor, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-6d6de0942b06540ca211eed323d5b7b755a6da787c35d1a15c5357d0b7548e8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Attended births</topic><topic>Births</topic><topic>Childbirth & labor</topic><topic>Datasets</topic><topic>Emergency medical care</topic><topic>Emergency Medicine</topic><topic>Emergency services</topic><topic>Fetuses</topic><topic>Hemorrhage</topic><topic>Information systems</topic><topic>Midwifery</topic><topic>Obstetrics/Gynecology</topic><topic>Prenatal care</topic><topic>Socioeconomic factors</topic><topic>Statistics</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eisenbrey, David</creatorcontrib><creatorcontrib>Dunne, Robert B</creatorcontrib><creatorcontrib>Fales, William</creatorcontrib><creatorcontrib>Torossian, Kristopher</creatorcontrib><creatorcontrib>Swor, Robert</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eisenbrey, David</au><au>Dunne, Robert B</au><au>Fales, William</au><au>Torossian, Kristopher</au><au>Swor, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Describing Prehospital Deliveries in the State of Michigan</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><date>2022-07-10</date><risdate>2022</risdate><volume>14</volume><issue>7</issue><spage>e26723</spage><epage>e26723</epage><pages>e26723-e26723</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>IntroductionWe observed clinically that prehospital deliveries locally appeared to have a high rate of complications and appeared associated with midwife deliveries. There is scant literature that addresses prehospital deliveries across a state. We set out to describe utilization, complications, and short-term outcomes of EMS-attended prehospital deliveries in Michigan in 2015, and to describe the relationship between prehospital delivery and socioeconomic status (SES).MethodsWe identified candidate cases for prehospital deliveries through the Michigan EMS Information System (MI-EMSIS). To assess the relationship of SES with the frequency of EMS delivery, we utilized the mean income of the patient residences' zip codes.ResultsWe identified 223 EMS-attended deliveries from 1.6 million MI-EMSIS records. Most births were normal vaginal deliveries on the scene or en route to the hospital (92, 40.0%) or delivered prior to EMS arrival (58, 25.4%). Maternal or fetal complications were identified in 69 (32.0%) deliveries. We identified a few midwife-attended deliveries (31), but these had a high rate of complications (19, 61.3%). The frequency of prehospital delivery was inversely related to estimated patient income (Pearson=-0.85).ConclusionsEMS deliveries were rare and most were normal vaginal deliveries, but almost a third had complications. Midwife and EMS-attended deliveries were rare, but when they occurred, had high rates of complications. Although an imperfect measure of patient SES, frequency of delivery was inversely related to patient income, and agencies that provide care in these communities should have focused training.</abstract><cop>Palo Alto</cop><pub>Cureus Inc</pub><pmid>35967190</pmid><doi>10.7759/cureus.26723</doi><oa>free_for_read</oa></addata></record> |
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subjects | Attended births Births Childbirth & labor Datasets Emergency medical care Emergency Medicine Emergency services Fetuses Hemorrhage Information systems Midwifery Obstetrics/Gynecology Prenatal care Socioeconomic factors Statistics Vagina |
title | Describing Prehospital Deliveries in the State of Michigan |
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