Developing evidence-based maternity care in Iran: a quality improvement study

Table 3 Evidence-based clinical recommendations.

	Not implemented routinely prior to intervention (n = 19)
Implemented routinely prior to intervention (n = 9)	Selected for intervention (n = 10)	Not selected for intervention (n = 9)
Amniotomy unless contraindicated	Admission in labour phase	Elective episiotomy
Nurse auscultory monitoring	Adequate pain relief (only by parenteral analgesics)	Vaginal birth after caesarean birth
Continuous electronic fetal monitoring-external (EFM-ext), if indicated	Non-use of routine enema	Restriction of elective caesarean birth
Documentation of progress of labour	Companionship (only after birth)	Alternative position for delivery
Regular cervical exam	Mobility during the first stage of labour	Continuous electronic fetal monitoring-internal (EFM-int), if indicated
Chart evaluation	Oral fluids	Amnioinfusion for meconium treatment and/or oligohydramnios
Operative vaginal delivery, if indicated	Remedial techniques in uteroplacental insufficiency or cord compromise	Vibroacoustic test or scalp stimulation
Prevention of postpartum haemorrhage	Management of arrest disorders	The scalp pH test
Management of high-risk situations such as preterm and post term labour, bleeding, gestational diabetes and hypertension	Management of protraction disorders	Fetal Pulse Oximetry (FPO)
	Active management of the third stage of labour

The left column shows the evidence-based clinical recommendations implemented routinely at the hospital. The next two columns display the result of professional consensus about which practices would be adopted in the new care model and which would not be adopted in the new model

ISSN: 1471-2393